Research shows New Zealand has one of the world’s highest rates of malnutrition among older adults with a recent study finding that up to 93% of those entering aged care in NZ are malnourished or at risk, compared with 20-50% of older adults in other countries.

The model is adaptive to specific food intolerances, allergies and other dietary and cultural needs and works by giving aged care residents a high level of control over their dining experience including menu design, recipe creation and food preparation and allowing them to work closely with, and in some cases, educate professional chefs.

An analysis of nutritional status data shows the malnutrition levels of residents on the programme improved from an average score of 9.1 (at risk of malnutrition) to 11.1 (well nourished) within 12 months.

New Zealand dietitians presented the model at the recent 6th World Congress on Aging and Geriatrics in Prague and have since been approached by healthcare providers and conference organisers in countries as far away as Portugal to discuss the approach.

“With research showing that almost all people entering aged care are malnourished or at nutrition risk, it presents a risk that this issue has been normalised within our society," Arvida dietitian and head of food service, Emily Jakubcik says.

“New Zealand has an ageing population and addressing our growing rates of malnutrition amongst this demographic will play an increasingly important role in maintaining quality of life and health outcomes. The Attitude of Living Well^TM model developed at Arvida works by giving aged care residents control over their dining experience. This includes involving them in menu planning and even allowing them to work alongside chefs and participate in food preparation in care centre kitchens. The aim is to replicate their individualised experience of home food preparation and consumption in a care setting."

Alison Ogg has seen her weight improve since becoming a resident of Arvida Aria Gardens retirement community in Albany Auckland more than a year ago. She checks the menu (featuring a summer menu that includes a meal alternative) every so often to see what’s being served.

“I get my five fruit and veges a day which is essential and I get my calcium which is important. I’m very satisfied with the food,” Alison says.

Jakubcik explains that resident involvement in meal design is part of a broader approach to helping older people remain engaged and connected within their new communities. She says the model supports over 1,500 residents in 24 Arvida care centres around the country.

“This approach is based around five core tenets of aged care health including moving, engaging, thinking, eating and resting well - to allow residents to self-drive their care experience. We have residents who have been engaged in cooking and meal preparation as their livelihood. That’s what they’ve been doing for 60 years, as a homemaker or in a professional career."

“At every level of meaningful engagement and activity, there is the resident voice, and it’s not just a tick box, it’s at every level. This includes having resident representation at a governance level - which is a first for this sector,” she says.

Jakubcik says they have moved away from traditional institutional practices that can contribute to malnutrition including changing the way they serve meals.

“Implementing buffet breakfast saw a shift away from institutional practice such as waking all residents at a set time and presenting them with a breakfast tray in bed. Instead, residents are left to wake naturally and supported to participate in choosing from a variety of breakfast items whilst they dine in an environment that includes the smell of warm toast and coffee; social companions and a meet and greet person who is available to support those who need it, while maintaining independence for those that do not."

Jakubcik says the model demonstrates how a shift in focus towards personalised care can significantly improve both nutritional outcomes and overall wellbeing for aged care residents, setting a new standard for facilities worldwide.

"By fostering a sense of community, purpose, and autonomy, it can enhance the overall quality of life for older adults. It also has the potential to reduce healthcare costs by preventing malnutrition-related complications and hospitalisations,” she says.