practical living
that data collection, the raw food spend decreased by $0.31
per resident per day over that time, and at the same time liquid
nutrition supplements spend actually increased by $0.50 per
resident per day.
So, as a dietitian, and with the Lantern Project centring on food
first and focusing on how we get the food right, that was quite
concerning. We’re seeing that homes are spending more on
supplements and less on actual food, and that’s not optimal when
we’re talking about quality of life for residents.
Have you or the authors had any consultation with
the government, especially with this renewed focus on
aged care?
Oh, absolutely. We’ve been in ongoing discussions. We’ve been
involved with the development of the nutrition and hydration
component of the guidelines for the new quality standards with
the former Aged Care Quality Agency. They’re going to be rolled
out on July 1 this year.
Obviously, this year’s going to be a bit of a challenge for aged
care, but we’re hoping that the work we’ve done is going to help
support the industry to transition to the new quality standards
and make it a little more simple.
You founded the Lantern Project in 2013. How did it come
about? Why aged care nutrition?
I’ve been a dietitian for 20 years, and when I began, the figure
that startled me was that one in two Australian aged care
residents were malnourished. I’ve been a clinical dietitian working
and managing a hospital for 10 years and also doing aged
care along the way, and now full time. That figure, over that
time throughout my career, did not change. So, it was really a
reflection: the Lantern Project started with me looking at my own
practice and saying, “Well, you know, we’re not being as effective
as we should be.”
And the answer lies in not just siloing the work and saying,
“As dietitians, we need to do something different.” Really,
Lantern’s looking at how, as a diverse group of aged care workers
– that is, nurses, catering staff, doctors, allied health, speech
pathologists, dietitians, physios and so on – how can we work
together to come up with novel solutions to fix this problem?
Because siloed work and me working as a dietitian alone is
obviously not fixing that statistic.
In the nearly six years since it started, have you noticed a
positive change in the nutrition of residents?
I’m absolutely seeing that we’re trending in the right direction,
although at the moment the focus – certainly with the Four
Corners program and then the announcement of the royal
commission – is around cases where things are not being done
properly, and that is inexcusable.
We’re looking at trying to raise the bar, and we’ve got a lot of
organisations now that engage. We’ve grown the engagement
from one month to the next with the Lantern Project
collaboration meetings. We average 80–100 people now at
each meeting, so people beam in from all over Australia and
internationally. We have over 850 people that link in and are
connected through the Lantern Project.
There’s increasing engagement, and they’re the kind of home
really being proactive and showing that they’ve got an appetite to
change. These stories don’t often capture the interest of media,
but I feel confident we’re moving in the right direction.
It seems to me that if you improve the nutrition and
therefore health of the patients, you would save millions of
dollars a year from health expenses. Can you put a figure on
that, or is that conjecture?
Well, there’s certainly more and more data coming together
demonstrating that it’s safe to invest in food, staffing and training
of staff around food and mealtime experience. So we’ve put more
resourcing into that mealtime experience. We know that we can
reduce worms, falls, medication, hospital readmissions and the
reliance on commercial nutrition supplements.
Supplements have a place, and they provide nutrition, but
they don’t provide what meals otherwise provide, which is
connection, social interaction, the triggering of memories and
the engagement of the senses.
The expense of having residents who are malnourished
certainly forms a big burden on the aged care sector and on the
government. We recently did a systematic review demonstrating
the cost-effectiveness of a nutrition approach. So it’s a safe
investment. There’s good data overseas too that can kind of help
to echo and support what we’ve been saying in the last five or six
years with Lantern.
You just mentioned the importance of the overall dining
experience. That’s part of your development of the Lantern
approach, I believe?
Yes, the Lantern approach is really the culmination of the last six
years. The PhD research that has gone into whether someone
gets to benefit from a meal is quite complex. There are so many
factors that can influence whether someone is going to consume
Supplements have a place ... but they
don’t provide what meals otherwise provide,
which is connection, social interaction, the
triggering of memories and the engagement
of the senses.
a meal, swallow it, and metabolise that meal. So we’ve really
pulled apart all the points from paddock to plate to the actual
digestion of the food, and all of these touch points help us to
answer the question: How do we maximise the opportunity for
someone to benefit from a meal?
The Lantern approach is pulling together all that information.
We’ve got seven evidence-based principles that we’ve pulled
together from the research and have demonstrated. We’re in the
process of demonstrating that across an organisation, which is
very exciting.
So, will you be working with a facility that will adhere to
these objectives and work closely with you?
For the last three or four months we’ve been living in an aged
care home and rolling out the Lantern approach across their
entire organisation. Once the outcomes of that process are able
to be published, we’ll certainly be sharing that Australia-wide.
The next step is putting forward the Lantern approach
with the royal commission as a model of care that should be
shared and should be something that aged care homes use a
guiding standard. ■
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