Strategies to Support Optimal Resident Nutrition

Kimberly Marsh

Kimberly Marsh, owner, The Low Iodine Dietitian

Nutrition plays an important role in all stages of life, but it’s particularly important that seniors receive adequate nutrition. Providing that customized, balanced nutrition in senior care settings can be a challenge, but there are many strategies you can use to ensure that all residents receive the nutrition they need to support their health.

Challenges in Senior Nutrition

Kimberly Marsh, owner of The Low Iodine Dietitian, has been a registered dietitian for 10 years and has consulted in senior care for six years. Marsh explains that ensuring older adults receive adequate nutrition can be challenging for multiple reasons. “Many have dental issues making it difficult to chew, but are also resistant to ground-up meats,” she says.

New residents are in an unfamiliar environment, so meal timing and seasoning might not be to their taste. It can also be challenging to balance dietary restrictions: “If someone on dialysis only wants to eat potatoes (which are restricted), you run into a real problem.”

Sharon Baker, a registered dietitian and former skilled nursing facility administrator, is currently a vice president at Capitol Hill Healthcare in Montgomery, Alabama. Baker notes that seniors can experience changes in smell and taste that may affect their eating habits. Medications may also alter seniors’ appetites, and changes in social status can all pose a challenge.

While ensuring residents receive appropriate nutrition can be difficult, it’s also an essential element of care that affects a resident’s health in multiple ways. “Adequate nutrition and hydration are vital to ensure our seniors have the energy to perform their activities of daily living and maintain a healthy weight,” says Baker. “Poor nutrition and hydration can result in a lack of energy and increase risk for negative outcomes such as falls, or unintended weight decline.”

How to Best Ensure Residents Receive Optimal Nutrition


Sharon Baker, registered dietitian and former skilled nursing facility administrator

When it comes to providing and monitoring optimal nutrition for residents, Marsh encourages senior care communities to get to know each resident and their typical eating patterns, preferences, and body type. Having this familiarity can help you to identify when a resident may be eating or acting differently, or when their bodies appear to be losing muscle. It can be helpful to monitor resident weight, muscle circumference, and hand grip.

Baker encourages communities to have a Registered Dietitian oversee the menu planning and modification, and those changes should also be monitored by facility leadership. It’s important to ensure that adequate and palatable meals are served. “In addition to assessing individual specific nutrition needs upon admission, they should be routinely assessed afterward and adjusted for significant changes by the registered dietitian,” says Baker.

She also highlights the importance of obtaining a resident’s medical and personal history as it relates to their nutrition status. If the resident can’t provide that information, then it’s important to engage with family members or those who know the resident best.

Senior care communities can also focus on including fortified foods in their meals. “Most facilities are too reliant on supplements for people who aren’t eating well,” says Marsh. “Adding more protein and calories to the regular foods residents like to eat will be most beneficial.”

Monitoring resident nutrition requires a team effort and an organized approach. Baker notes that the interdisciplinary care team is vital to this process, and that team includes, but is not limited to, administration, nursing, food and nutrition services, social services activities, and therapy. “Daily stand-up, special huddles, weekly departmental, and routine care plan meetings are great places to communicate the nutrition status of the residents,” she explains.

Evaluating Nutrition Performance

If a senior care community were to evaluate how well it’s providing residents with the nutrition they need, Baker advocates starting with the residents, themselves. “Establish a focused resident council to solicit input regarding daily menu and snack choices, holiday celebration meals, and overall satisfaction with all aspects of meal service,” she recommends. Marsh notes that a community’s rates of UTIs, pressure ulcers, weight loss, and supplement use can also provide key indicators about the performance of its nutrition program.

With so many priorities, it’s easy to overlook the importance of monitoring and reevaluating nutrition, but that would be a disservice to residents. “Nutrition has a major impact on the quality of life for our seniors,” says Baker. “We all have a role in ensuring optimal nutrition for our residents.”

Topics: Activities , Featured Articles , Leadership , Resident Care , Senior Environments