Author: Daniela Alvaran Corzo

In the Netherlands, about one in seven people above the age of 80 live in nursing homes (Meyboom-de Jong et. al. 2018). This decision to leave one’s own home behind is not one taken lightly: Often, a combination of advanced age, chronic diseases, weak social networks and low income simply leaves no alternative (Meyboom-de Jong et. al. 2018).

Dutch nursing homes provide integral services, care and support for men and women aged 65 and older. Residents of nursing homes may require specialized care by a registered nurse, such as medical monitoring and treatments. They also receive support through custodial care however. This includes tasks such as bathing, getting dressed, and importantly, eating (Meyboom-de Jong et. al. 2018).

Malnutrition among the Elder Population

The Food and Agriculture Organization of the United Nations (UN) identifies four pillars of food security: availability, access, utilization and stability (Napoli et. al. 2011). Failure to ensure all four pillars can result in malnutrition, in other words an imbalance between nutrient intake and the body’s requirements.

Malnutrition is a serious problem, significantly contributing to morbidity and mortality among the elder population (WHO 2021). Common consequences of malnutrition include a weak immune system, raising the risk of infections, poor wound healing, muscle weakness and decreased bone mass, leading to falls and fractures, and a higher risk of hospitalization (Mayo Clinic Staff 2019).

Nutrition in Dutch Nursing Homes

Despite the importance of proper nutrition however, an investigation carried out by the Dutch Health Care Inspectorate on Dutch nursing homes found among other issues a lack of preventative measures against malnourishment (Ministry of Health, Welfare and Sport 2018a). In fact, research shows that although most nursing homes in the Netherlands have nutritionist services, in 2014 only 36.7 percent of residents in Dutch nursing homes were examined by a dietician (Nie-Visser 2014). Moreover, only three quarters of the residents were screened during their admission, a measure crucial to prevent malnourishment because it allows for the identification of undiagnosed diseases and allows a resident’s weight and nutritional intake to be properly monitored (Nie-Visser 2014). Finally, nutritional interventions such as energy-enriched snacks between meals and tube feeding were not found to be common in most Dutch nursing homes.

Due to these shortcomings, around 20 to 25 percent of nursing home residents in the Netherlands are considered malnourished (Nie-Visser 2014). One major contributing factor to this problem is the insufficient number of care-workers. Currently, the time required to implement feeding assistance exceeds the nursing staff capacity, thereby worsening the prevalence of malnourishment. Increasing staff personnel as quickly as possible to ensure better feeding assistance for the nursing home residents during mealtimes is thus crucial (Nie-Visser 2014).

Improving the Quality of Care in Dutch Nursing Homes

Since 2017, the Dutch government has been launching programs to improve the quality of life for nursing home residents. It has placed particular emphasis on providing better education and training to care professionals and ensuring more transparency about the quality of care received by the residents (Ministry of Health, Welfare and Sport 2018).

Within this scheme, the prevention of malnourishment should take on a higher priority. Possible solutions to reduce malnutrition in nursing homes include giving residents who cannot feed themselves one-on-one assistance during mealtimes. In addition, there should be greater efforts directed towards making mealtimes experiences enjoyable, starting with ensuring that residents feel free from time constraints and pressure when eating.

References:

Mayo Clinic Staff (2019). “Senior health: How to prevent and detect malnutrition.” Mayo Clinic. At https://www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/senior-health/art-20044699#:~:text=Malnutrition%20in%20older%20adults%20can,lead%20to%20falls%20and%20fractures.

Meyboom-de Jong, B., K. Wynia, and A. Geluk-Bleumink (2018). “Ageing Better in the Netherlands.” Gerontology: 101-111.

Ministry of Health, Welfare and Sport (2018). “Improving elder care in nursing homes.” Government of the Netherlands. At https://www.government.nl/topics/nursing-homes-and-residential-care/improving-elder-care-in-nursing-homes.

Ministry of Health, Welfare and Sport (2018a). “Nursing Homes and Residential Care.” Government of the Netherlands. At https://www.government.nl/topics/nursing-homes-and-residential-care.

Napoli, M., P. De Muro and M. Mazziotta (2011). “Towards a food insecurity Multidimensional Index (FIMI).” Master in Human Development and Food Security, 1-72.

WHO 2021. “Nutrition for older persons.” World Health Organization. At https://www.who.int/nutrition/topics/ageing/en/.

van Nie-Visser, N. C. (2014). “Malnutrition in Nursing Home Residents in the Netherlands, Germany and Austria: Exploring and Comparing Influencing Factors.” Health Services Research.