Increasing Intake to Decrease Malnutrition in Long-Term Care (LTC) Settings

Malnutrition is a serious issue in long-term care (LTC) homes, affecting many residents. It can lead to weaker immune systems, longer recovery times, and higher risks of infections. As Nutrition Managers, we play a crucial role in helping residents, particularly those with cognitive impairments like dementia; get the right nutrition to stay healthy. This blog will explore the causes of malnutrition in LTC settings and share practical, research-backed ideas to increase food intake and reduce malnutrition.

Understanding the Challenge of Malnutrition in LTC

Malnutrition in older adults can happen for several reasons. Some of the most common causes in LTC are:

1. Loss of Appetite: As people age or deal with illness, they often lose interest in eating.
2. Difficulty Chewing or Swallowing: Conditions like difficulty swallowing (dysphagia) or dental issues can make eating harder.
3. Cognitive Decline (including Dementia): Residents with dementia may forget to eat, lose interest in food, or not recognize hunger cues. This often leads to inadequate food intake and malnutrition.
4. Boring or Unappealing Meals: If the food is bland or not to their liking, residents may not want to eat.
5. Social Isolation: Eating alone can make mealtime less enjoyable and may lead to poor food intake.

Understanding these issues helps us come up with ways to encourage residents to eat more and improve their nutrition.

Ways to Increase Food Intake

Here are some practical ways to increase food intake and fight malnutrition in LTC settings:

1. Make Meals More Appealing

The way food looks and smells matters a lot when it comes to stimulating appetite. If meals are colorful, tasty, and nicely presented, residents are more likely to eat.

• Tip: Add some fresh herbs, colorful vegetables, or fun food garnishes to make meals more exciting.
• Evidence: Research has shown that when food is presented nicely, residents tend to eat more (Navarro et al., 2016).

2. Focus on Nutrient-Dense Foods

When appetite is low, it’s important to serve foods that pack a lot of nutrition in a small portion. This means offering foods that are high in calories, protein, and essential vitamins, without overwhelming the resident with large portions.

• Examples: Fortified shakes, high-calorie smoothies, cheese, and soups can provide a lot of nutrition without requiring a lot of food.
• Evidence: Studies show that including these nutrient-dense options can significantly improve the nutritional status of older adults in care (Sossen, Bonham, & Porter, 2021).

3. Improve the Dining Environment

The environment where residents eat also plays a big role in their food intake. A comfortable, social, and pleasant setting can help stimulate appetite.

• Tip: Make sure the dining area is well-lit, quiet, and free from distractions. Allow residents to eat with others to encourage conversation and socializing during meals.

4. Personalize Meal Plans

Every resident has different tastes and nutritional needs. Some may need softer foods due to dental issues or swallowing problems, while others may have special dietary needs because of medical conditions.

• Tip: Work with the healthcare team to create personalized meal plans that fit each resident’s needs, preferences, and medical conditions.
• Evidence: Research shows that when meals are tailored to individual needs, it can reduce the prevalence of malnutrition (Volkert et al., 2015).

5. Let Residents Help with Meal Choices

Involving residents in choosing their meals can make them more excited about eating. Giving them a say in the food they get to enjoy can increase their overall food intake.

• Tip: Hold regular “menu review” sessions where residents can help pick what’s served or ask for feedback on their food preferences.

6. Make Sure Residents Stay Hydrated

Sometimes, dehydration can cause a loss of appetite and make it even harder for residents to eat. Offering a variety of drinks throughout the day can help keep residents hydrated and support their appetite.

• Tip: Offer flavored waters, herbal teas, or fresh juice to encourage drinking and keep hydration levels up.
• Evidence: Research shows that staying hydrated helps improve food intake and nutritional health in LTC residents (Beck et al., 2023).

Malnutrition is a complex issue, but there are many ways we can increase food intake and improve the health of LTC residents. By making meals more appetizing, offering nutrient-dense foods, personalizing diets, and ensuring hydration, we can help our residents get the nutrition they need. It’s important for everyone in the care team to work together to reduce malnutrition and improve quality of life for our residents.

In the end, it’s not just about serving more food—it’s about serving the right food in a way that makes it easier and more enjoyable for residents to eat.