Development of the Australian National Meal Guidelines for home‐delivered and centre‐based meal programs for older adults

Abstract

In 2017, the number of Australians aged 65 years and over (older adults) increased from 1.3 million in 1977 to 3.8 million, and is projected to increase to 8.8 million by 2057. 1 The health of the increasing number of older Australians presents an economic challenge 2 with estimations that in 2050, over 3.5 million Australians will be accessing aged care services. Home and community care services have been provided in Australia for more than a century. The 1960s, 1970s and 1980s saw increased government funding and new legislation to encourage community-based services for older adults. This included the Delivered Meals Subsidy Act, in 1970, followed by the Home and Community Care (HACC) program, part of the Australian government's 1980s aged care reform aimed at increasing community services and reducing expenditure on residential aged care

Audit of the national meal guidelines for home‐delivered and centre‐based meal programs

“…11 During the development of the guidelines, key stakeholders were given the opportunity to express their concerns regarding the implementation of the guidelines. 9,11 Stakeholders expressed concerns regarding the difficulties of meeting the guidelines, especially in small or rural areas. They also identified perceived increased cost, supplier compliance, customer acceptance and staff engagement as potential barriers for implementing the guidelines.…”

“…The first nutrition standards for home-delivered meal programs were released in 1977 by the Commonwealth Department of Health. 9 From there, state-based guidelines were released in the early 2000s, but these documents varied significantly between states and some lacked specific nutrition recommendations. 10 These inconsistencies highlighted a need for a national set of guidelines to support meal programs in delivering their essential services.…”

“…13 The development of the National Meal Guidelines was an extensive process that involved a systematic literature review, 14 six face-to-face workshops with key stakeholders and two surveys with MOW customers, service providers, caterers and health professionals. 9 As part of the development of the National Meal Guidelines, Clancy et al 11 surveyed 289 service providers and health professionals to ascertain their views and suggestions regarding the guidelines. The resulting document was considered a 'landmark document' 13 that provided community-based meal programs with the information and tools they required to create adequate and nourishing menus for older adults.…”

“…The guidelines that support these organisations have also changed as new evidence has emerged and methods of best practice have been adapted. The first nutrition standards for home‐delivered meal programs were released in 1977 by the Commonwealth Department of Health 9 . From there, state‐based guidelines were released in the early 2000s, but these documents varied significantly between states and some lacked specific nutrition recommendations 10 .…”

Food provision to support improved nutrition and well-being of people experiencing disadvantage – perspectives of service providers

“…Hence, newly developed nutrition standards and accompanying training tools for staff and volunteers could potentially facilitate the attainment of adequate nutritional quality for clients of charitable organisations in a cost-effective way. The nutrition standards could be based on those already in use in healthcare facilities ( 47 ) or home-delivered and centre-based meal programmes ( 48 ) , which are holistic in nature and encompass accommodation standards and educational toolkits ( 49 , 50 ) . The nutrition standards would ideally extend beyond nutritional adequacy to consider client psychosocial needs and would involve service users in the menu design (including menu cycles) and selection of food items ( 47 ) (including minimum numbers of food choices).…”