Provision of adequate nutrition and dealing with obstacles to delivering adequate nutrition in care facilities for the elderly
- 14.07.2025
- English Articles
- Franziska Kochler
- Maren Peuker
- Kathrin Kohlenberg-Müller
Peer reviewed / Manuscript (original) submitted: 28.04.2024; revision accepted: 21.10.2024
A descriptive study from the perspective of care home staff
Introduction
According to estimates, the number of people requiring care in Germany will rise to 6.5 million by 2050 [1]. The proportion of people requiring care who receive residential care (in a care home) increases with age. In 2021, 16% of the total 4.96 million people requiring care in Germany were being cared for in care homes [2]. Care home residents receive comprehensive personal and domestic care [3], which includes all meals [4]. The quality of the food provided is important, but it is also important that care home staff observe eating behavior and support residents with their eating. Because care homes use the “Bezugspflege”1 model (primary care model), staff are familiar with residents’ needs and preferences. Using their care expertise, care home staff assess the individual resident’s2 nutritional situation and recognize when their eating habits or food intake change and when there may be a nutritional supply problem. Since residents usually live in care homes for the rest of their lives, it is essential that they receive continuous, personalized nutrition care that meets their needs, along with tailored nutritional interventions [4].
In care homes, there is an increased risk of malnutrition, which can come with serious consequences. People requiring care often experience a loss of appetite, have difficulty swallowing or have cognitive impairments, all of which can make eating difficult or even impossible. In addition, there are various diseases that are associated with disorders of nutrient metabolism and/or increased energy and nutrient requirements [5]. Analysis of the 2018 nutritionDay data for Germany showed that 23% of care home residents were underweight, 14% had unintentional weight loss and 10.5% were considered malnourished by care home staff [5]. Only 30% of the participating care homes reported that they had access to a dietitian. By contrast, 85.7% of care homes across Europe have access to a dietitian. This means that there is a significant lack of nutritional medicine expertise in German care homes [5]. ...
Abstract
The prevalence of nutritional problems is high in care homes for the elderly. The aim of the quantitative study was to investigate the provision of nutrition and how care home staff deal with nutritional supply problems from their perspective.
The paper-and-pencil survey was aimed at general nursing care staff, assistant care staff and other caregiving staff from six care homes for the elderly run by a single organization. Of the 104 datasets, 80 were able to be statistically assessed, and the open questions were analyzed using qualitative content analysis according to the Mayring method. General nursing care staff and nursing assistants in particular stated that they were responsible for identifying and solving problems with residents’ nutrition. To do this, they use a variety of methods such as observing eating and drinking behavior or nutrition/plate protocols. 18.7% of the respondents said they often succeeded in solving the residents’ nutritional supply problems, and 40.0% said they were quite often able to do so. The majority of respondents rated their nutrition knowledge as average.
Care home staff require training in identifying and solving residents’ nutritional supply problems. The expertise of nutrition professionals should be more fully integrated into care homes to improve residents’ nutrition.
