For elderly residents living in care homes, good nutrition plays a key role in supporting overall health, improving quality of life, and reducing the risk of illness and hospital admissions. Malnutrition in older adults is a significant concern in the UK, with research suggesting that around 1 in 10 people over the age of 65 are malnourished or at risk of malnutrition. 

For care home teams and healthcare professionals who work with the elderly, ensuring that residents receive adequate, balanced nutrition is a daily priority. But it’s not just about what’s on offer at mealtimes; nutrition in a care setting requires a holistic approach that takes into account individuals’ physical, emotional, and social needs.

In this blog, we’ll explore practical tips and best practices to support good nutrition among elderly residents in care.

The signs of malnutrition can sometimes be subtle and easy to overlook, but it can severely affect well-being, so it’s important to know the warning signs, which include:

• Unexplained weight loss – you may notice clothes becoming loose, for example
• Fatigue and lack of energy
• Loss of appetite or interest in food

The impact of malnutrition will be seen in both a person’s mental and physical health – not getting the right balance of nutrients from food can result in:

• Depression and low mood
• Muscle weakness
• An increased risk of falling
• Increased risk of pressure sores
• Reduced resistance to infection due to an impaired immune response
• Overall reduced quality of life

The National Institute for Health and Care Excellence (NICE) defines a person as being malnourished if they have:

• A body mass index (BMI) of less than 18.5kg/m2
• Unintentional weight loss greater than 10% within the past three to six months
• A BMI less than 20kg/m2 and intentional weight loss greater than 5% within the past 3–6 months

So it’s essential that residents’ food intake and weight is monitored closely. Screening tools like the Malnutrition Universal Screening Tool (MUST) can be used to identify residents at risk early – it’s recommended you screen each individual upon admission and then monthly thereafter. 

As we age, our bodies process food differently, so our nutritional needs change. However, a 2024 report by the Malnutrition Task Force warns against simply accepting that becoming thinner and more frail is “all but inevitable in later life”.  

Older adults tend to need:

• Fewer calories, but more nutrient-dense foods rich in vitamins and minerals
• Increased protein to support muscle mass and prevent frailty
• Adequate fibre to support digestive health
• Plenty of hydration, as the sense of thirst may decrease with age

Vitamin D and calcium are especially important for bone health, and B12 absorption can decrease with age, making regular nutritional assessments essential.

The dining experience in care homes should be as enjoyable as possible. A calm, welcoming setting encourages residents to eat more and see mealtimes as something to look forward to. Consider the following:

• Meals that look and smell appetising
• Communal dining when appropriate, to promote social interaction
• Aids required to make eating and drinking easier – dentures, glasses, adapted cutlery and any other equipment
• Reduce distractions such as loud TVs or interruptions

Staff involvement during mealtimes can also make a big difference. Sit with residents, talk with them, and offer gentle encouragement without pressure

Residents are more likely to eat well when offered food they enjoy. Build menus that:

• Allow residents to choose for themselves wherever possible
• Take personal preferences into account
• Include familiar favourites alongside new or seasonal options
• Offer alternative textures for those with swallowing difficulties (dysphagia), ensuring modified diets still look and taste appealing

Where possible, involve residents in planning menus or provide feedback forms to understand what they enjoy.

Many elderly residents have medical or cognitive conditions that affect their eating habits. For example:

• People living with dementia may forget to eat or lose interest in meals
• Residents with dysphagia need careful texture modification to reduce choking risk
• Those with mobility issues may struggle to feed themselves

In these cases, tailored support is crucial. Care staff should be familiar with each resident’s care plan and feeding needs. Encourage independence where possible, but always be ready to provide discreet assistance

Dehydration is a common problem in older adults and can lead to urinary tract infections, confusion, and falls – and is even more important in the summer months. Encourage residents to drink:

• Water, milk, or juice regularly throughout the day
• Herbal teas or decaffeinated options, if they prefer them
• High-fluid snacks such as fruit, jelly, or soups

Set hydration routines, offer drinks with every interaction, and consider hydration stations in communal areas.

Good nutrition in a care setting goes far beyond simply providing three meals a day – it should be firmly embedded into a wider culture of care. Ongoing staff training and mealtime assistance can empower your care teams to spot issues early and respond effectively. Use regular team meetings to share insights, celebrate improvements, and keep everyone aligned on the importance of nutritional care.

Residents’ families can provide useful insights into a resident’s past eating habits and preferences, so where possible, have an open dialogue with family members to support continuity of care. Involve dietitians, GPs, and other medical staff where possible; a team-based approach ensures that nutritional care is integrated into the care plan and adapts as needs change.

By focusing on prevention, personalisation, and compassionate support, care homes can play a crucial role in helping older people stay well-nourished, comfortable, and healthy in later life.