Long-term or residential services are designed to support older people who experience challenges to their physical and mental health. These services play an important role in the health and well-being of older adults who are more susceptible to problems such as malnutrition. Estimates of the significance of malnutrition require up-to-date prevalence data to inform government strategies and regulation, but these data are not currently available in Australia. The aim of this study was to collect malnutrition prevalence data on a large sample of people living in residential aged care facilities in Australia. A secondary aim was to examine the relationship between malnutrition and anthropometry (body mass index (BMI) and weight loss). This prevalence study utilised baseline data collected as part of a longitudinal study of malnutrition in 10 Residential Aged Care facilities across three states in Australia (New South Wales, South Australia, and Queensland). The malnutrition status of eligible residents was assessed by dietitians and trained student dietitians using the Subjective Global Assessment (SGA) with residents categorised into SGA-A = well nourished, SGA-B = mildly/moderately malnourished, and SGA-C = severely malnourished. Other data were extracted from the electronic record. Of the 833 listed residents, 711 residents were eligible and had sufficient data to be included in the analysis. Residents were predominantly female (63%) with a mean (SD) age of 84 (8.36) years and a mean (SD) BMI of 26.74 (6.59) kg/m2. A total of 40% of residents were categorised as malnourished with 34% (n = 241) categorised as SGA-B, and 6% (n = 42) SGA-C. Compared to the SGA, BMI and weight loss categorisation of malnutrition demonstrated low sensitivity and high specificity. These findings provide recent, valid data on malnutrition prevalence and highlight the limitations of current Australian practices that rely on anthropometric measures that under-detect malnutrition. There is an urgent need to implement a feasible aged care resident screening program to address the highly prevalent condition of malnutrition in Australia.
Aims: To test a model of malnutrition screening and assessment conducted by dietetics students on placement in residential aged care facilities. The secondary aim was to identify possible facilitators and barriers to the implementation of the model.Method: The type 1 hybrid effectiveness‐implementation trial study design and reporting outcomes were developed using the Consolidated Framework for Implementation Research. An innovative placement model was developed, where students on voluntary placement visited three residential aged care facilities to identify residents at risk of malnutrition using currently available screening tools for older people. Students completed malnutrition assessments for all residents using the subjective global assessment tool.Results: Thirty‐two students participated; 31 completed all three sessions, with malnutrition screening completed for 207 residents and malnutrition assessment for 187 residents (July and September 2022). Based on the subjective global assessment, 31% (n = 57) of residents were mildly/moderately malnourished, and 3% (n = 5) were severely malnourished. The Innovation Domain of the Framework was the most important consideration before implementation.Conclusion: Whilst previous research documented student learning opportunities in residential aged care facilities, this study provides the first available evidence of the direct contribution students can make to the health of aged care residents through malnutrition screening and assessment. The model enables students to conduct malnutrition screening and assessment feasibly and efficiently in facilities that do not routinely collate and act on these data. With a limited nursing aged care workforce to undertake this vital task, the potential role of student dietitians to fulfil this role must be considered.
Background: Dementia care requires a skilled workforce, yet access to scalable and effective training for formal caregivers, including nurses, remains inconsistent. Digital education is a potential solution, but effectiveness is unclear. Aims: To examine digital dementia training programmes for formal caregivers and map their reported effects on knowledge, self-efficacy and skills. Methods: A scoping review was conducted using the Arksey and O’Malley framework and reported according to Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Five electronic databases were searched for peer-reviewed studies evaluating fully digital dementia training interventions for formal caregivers. Methodological quality and reporting completeness were assessed using the Mixed-Methods Appraisal Tool and the Guideline for Reporting Evidence-based Educational Interventions and Teaching checklist. Findings were synthesised narratively. Results: Eighteen studies met the inclusion criteria. Digital training (online and microlearning) was associated with improvements in dementia-related knowledge and self-efficacy. Flexibility and accessibility were key advantages. However, evidence of skill development and behavioural change was limited, predominantly based on self-reported outcomes. Direct care workers were underrepresented. Conclusions: Digital dementia training offers flexible, scalable workforce education for those caring for people living with dementia. However, limited evidence on practice change constrains its application. Further research is needed to inform theory, guide implementation and support policy decisions regarding effective workforce training.