How do we move beyond “add a supplement” and build everyday mealtime wellbeing? Registered dietitian Terryn Choat shares a practical, person-centred approach: earlier screening, smarter documentation, and food-based strategies that lift dignity, energy, and outcomes. We cover why BMI alone misleads in older adults, how to spot red flags sooner, and the culture shifts that help kitchen, clinical, and care teams work as one. We also touch on how systems like VCare support screening, tracking, and continuity of care.

Key takeaways:

• Access enables care. Give dietitians read access to clinical systems (e.g., VCare) and relevant policies; it speeds decisions, reduces gaps, and aligns plans with site workflows.

• Use the right screen. In long-stay care, MNA (Mini Nutritional Assessment) often outperforms MUST because it captures appetite, mobility, mood, and muscle—early signals before weight shifts.

• Rethink BMI for older adults. Standard cut-offs miss risk. Evidence suggests lowest mortality around BMI 24–31; “underweight” risk can begin ≈23—act sooner, not later.

• Spot red flags early. Subtle appetite drops, skipped meals, wounds that stall, recurrent infections, fatigue, mobility change, swallowing issues—refer early, don’t “wait and see.”

• Supplements/laxatives aren’t a strategy. Over-reliance masks root causes, dulls appetite, and can cause dehydration or bowel dependence. Use as back-up, not default.

• Go food-first. Fortify familiar foods (cream in soups, cheese in mash, milk powder in custards/smoothies), add protein-rich options, offer small frequent meals, and pair sessions with protein snacks.

• Hydration helps. Nourishing fluids (e.g., smoothies) support both intake and hydration—especially with low appetite.

• Make movement social—so is food. Pleasant dining spaces, walking to activities, and mealtime connection lift intake and mood.

• Align with the home’s culture. Plans work when they fit the site’s values, staffing, and menu—co-design with kitchen, RNs, and care teams.

• Train everyone. Whole-team education (nursing, HCAs, kitchen, housekeeping, gardeners) reduces falls and catches risk sooner.

• Document to improve. Build screening + triggers into the system; track weight, intake, fluids, goals, and progress to adjust quickly and maintain continuity.

• Proactive beats reactive. Invest in dietetic expertise, standardise referral criteria, and embed nutrition into daily routines—it lifts wellbeing, reduces hospitalisations, and supports staff.

• Start today. Make mealtime conversations routine: ask what residents enjoy, note what’s left, and act on early changes.