Malnutrition prevalence and nutrition issues in residential aged care facilities.

OBJECTIVES: To determine the prevalence of malnutrition and investigate nutritional issues in a sample of older people living in residential aged care facilities (RACFs). METHOD: This study forms the descriptive component of a pretest post-test designed study conducted in eight RACFs. The Subject Global Assessment tool was used to determine the prevalence of malnutrition in 350 residents. RESULTS: Nearly 70% of residents were women and 79.4% of all residents were classified as high care. Half the residents were well nourished (50.5%) with 43.1% moderately malnourished and 6.4% severely malnourished. Prevalence of malnutrition was significantly higher for residents receiving higher level care (odds ratio (OR) = 2.9 (95% confidence interval (CI): 1.7-5.2; P < 0.001)) and older than 90 years (OR = 3.0 (95% CI: 1.8-5.1; P < 0.001)). Of the residents considered to be malnourished, very few (17.8%) had been seen by a dietitian in the past 6 months or were receiving commercial supplements (29.2%). CONCLUSIONS: There is a need for systematic, coordinated and multidisciplinary approaches to nutritional care for older people in residential care.

Challenges associated with implementing an education program in a residential aged care setting.

The link between independence and well-being of older people in residential care is well established. This paper reports some challenges encountered during implementation of an education program designed to assist nursing staff to adopt an independence-supporting model of residential care. The education program was part of a larger project aimed at developing an example of best practice in supported care which promotes independence, well-being and community linkages. Implementation of the program created many interesting challenges which were overcome by strategies and facilitating forces such as support from management and some staff and the collaborative nature of the project. Positive outcomes of the education program included increased awareness of and change in, practice; increased staff-resident interaction; and increased encouragement for residents to be independent and to engage with the wider community. Moreover, a facilitator manual - Promoting Independence: A Learning Resource for Aged Care Workers was subsequently developed so that the program can be implemented in aged care facilities elsewhere.

University and industry partnerships: lessons from collaborative research.

Collaborative research between educational institutions and health agencies is being increasingly used as a method of achieving joint outcomes and bringing together theory and practice. This paper reports on the experiences of collaboration that arose out of just such a project carried out in a residential aged care setting. The research team included university academics, two nurses in management positions in the aged care facility and a senior research assistant. In this paper, we explore some of the unexpected issues that emerged during implementation of the research project. The major challenges to successful collaboration arose not from within the collaborative research team, but from the responses of the broader staff who generally had little, if any, experience of research. Despite efforts to inform and involve staff, deep suspicions about the 'real' motives of the project proved difficult to shift. Trust and commitment are vital dimensions of successful collaborative research, yet gaining these from some staff proved elusive. Collaborative relationships between educational and practice settings need to be viewed as long-term endeavours driven by a common unifying goal to enhance client care. This has implications for costs and timelines which might be difficult to manage.