In this guest post, Andrew Martin, founder of Eat Well Health, argues that nutrition failures in aged care stem from vague workflows. He suggests consistent screening, clear escalation, dietitian plans and nutrition supports to help close the gap between concern and action.
Under Support at Home, meal services are a clear, fundable support, and the stronger emphasis on meals being nutritious is a genuinely positive step. But meals aren’t the whole nutrition story. For a meaningful subset of older people, you can have meals available and still have declining intake.
You see it when appetite is low after illness, when fatigue makes “three meals a day” unrealistic, when chewing or swallowing is difficult, or when someone is losing weight even though support is in place. In those situations, “more meals” isn’t always the answer, but it’s often the only lever the system pulls reliably.
Most care teams notice the warning signs early. The problem is what happens next. Too often, the pathway from “I’m worried about intake” to an actual, documented nutrition plan is slow, inconsistent, and hard to repeat across an organisation.
As Support at Home increases expectations around care planning and evidence of good practice, nutrition is one of the easiest places for providers to improve consistency, if the process is designed so that frontline teams aren’t carrying extra admin.
The gap isn’t awareness. It’s follow-through.
In my experience, nutrition doesn’t fall over because providers don’t care. It falls over because the workflow is vague.
It usually looks like this:
- A concern is noted (“not eating much”, “lost weight”), but it isn’t captured in a repeatable way.
- Dietitian access varies by location and capacity, so escalation drifts.
- Staff aren’t always sure what documentation is needed to progress a plan.
- Even when a recommendation is clear, sourcing the right nutrition support can be harder than it should be — it may sit outside normal purchasing systems, the ordering pathway isn’t obvious, and follow-through becomes patchy.
That’s not a clinical problem. It’s an operating model problem.
What a workable model looks like
The providers who do this well treat nutrition like other risk domains: identify risk early, escalate cleanly, document the plan, and make the next step easy.
At Eat Well Health, we built this workflow so providers can screen consistently (via an online screening assessment informed by the validated MNA-SF framework and its underlying principles), produce or upload dietitian recommendations, and make the next step simple to action and document without adding workload to frontline teams.
In practice, three elements matter:
1) A short online screen, used at predictable moments
The win isn’t the screen itself — it’s consistency. Screening works best when it’s triggered during onboarding and scheduled reviews, and also post-hospital or when staff observe appetite/weight/function change. Online matters because it’s repeatable, remote-friendly, and can be completed by staff, a client, or a carer.
2) A dietitian recommendation that’s documented and easy to action
Once risk is flagged, there needs to be a straightforward pathway to a recommendation that is written clearly and stored in a consistent format. For some providers, that’s an in-house dietitian team receiving a structured summary. For others, it’s our dietitian telehealth capacity (or surge support) producing the same standard output. Either way, care teams shouldn’t be left guessing what happens next.
3) A broader view of nutrition support — not just meals
A practical nutrition plan might include food-first changes (fortification, snack structure, assistance at mealtimes). But for some clients, it may also include oral nutrition support — not as a “product push,” but as part of a dietitian-led plan with clear consent and documentation.
When supplied as part of a documented dietitian intervention and billed within Clinical Support – Nutrition & Dietetics, nutrition support can often be provided with no participant contribution, assuming budget and documentation requirements are met. (This is the approach we’ve built at Eat Well Health — online screening informed by MNA-SF domains, dietitian sign-off, and a claim-ready recommendation.)
If I ran a provider tomorrow, I’d start here:
You don’t need a big transformation to materially improve nutrition follow-through. I’d start with three moves:
- Make screening standard practice at two trigger points: onboarding + scheduled reviews.
- Define the escalation pathway (in-house or telehealth) and standardise the recommendation template.
- Agree on what “nutrition support” includes so staff aren’t improvising — and meals aren’t treated as the only option by default.
Nutrition is more than meals. Providers who operationalise that reality with a simple, documented workflow reduce the drift between “concern” and “action” — and build a much cleaner evidence trail of consistent practice.
