Peer-reviewed | Manuscript received: August 26, 2016 | Revision accepted: November 08, 2016
As a result of demographic developments, an increasing number of older people live in inpatient institutions. As the number of very old people has continued to rise and the need for care in old age has continued to increase, traditional retirement homes where older people live in sheltered accommodation, have increasingly developed into so-called nursing homes, where old people are provided with long-term care. Based on current statistics provided by the Statistisches Bundesamt (Federal Statistical Office of Germany), 764,000 people – almost a third of those in need of care – were cared for in approx. 13,000 SGB XI-approved nursing homes in Germany at the end of 2013. Almost 11,000 of these institutions provide full-time long-term care; the remaining number offer exclusively short-term or part-time care. Almost all institutions (94%) care primarily for older people .
In 2013, 1 in 5 nursing home residents was in need of intensive nursing care (Care Level 3); almost two-thirds were severely limited in their ability to cope with everyday life . These limitations are often accompanied by nutrition problems such as loss of appetite, difficulties in chewing and swallowing and the need for help when eating, which are in turn associated with a low consumption of food and a high risk of malnutrition [2–5].
1 This article is an abridged version of the chapter of the same name in the Ernährungsbericht 2016 (Nutrition Report 2016) produced by the Deutsche Gesellschaft für Ernährung (DGE) (German Nutrition Society).
2 With support from the Bundesministerium für Ernährung und Landwirtschaft (BMEL) (Federal Ministry of Food and Agriculture).
The objective of this study was to evaluate awareness, acceptance, implementation and effects of the “DGE Quality Standard (QSt) for Catering in Institutions for Older People.” 590 institutions for older people with varying proportions of care-dependent residents took part in a national written survey. Extensive telephone interviews were carried out with a sub-sample of 75 catering managers. Two thirds of participating institutions were aware of the QSt; most of these had also implemented the QSt, at least in part, and regarded the QSt as helpful. Some criteria in the quality areas of “food” and “nutrients” were significantly more frequently fulfilled by the institutions which were aware of the QSt than by those which were not. All the surveyed criteria in the remaining quality areas were fulfilled by the majority of institutions, irrespective of their awareness of the QSt. The most frequently-mentioned effects of the implementation of the QSt were changes in the frequency of use of certain food groups, a greater number of choices and increases in the costs of goods and in resident satisfaction. The greatest obstacles to implementation of the QSt were costs and tight budgets, lack of time and lack of acceptance of certain food groups. These results should serve as a basis for further development of the QSt.
Keywords: institutions for older people, catering, DGE Quality Standard, nursing home