Landmark national research has uncovered a hidden and growing health crisis among older people living at home: quietly declining nutrition. Multi-modal research suggests that this problem has less to do with access to food, and a lot to do with motivation, loneliness and the loss of a reason to cook among older people.
HomePlate Insights, led by the Maggie Beer Foundation and funded by the Wicking Trust, is the most comprehensive study of its kind ever conducted in Australia. It combines a national survey of almost 2,500 older people, in-depth interviews and focus groups with more than 230 older people across regional and metropolitan Australia, and a University of Sydney literature review.
The findings show one in five older people describe their eating as merely ‘good enough’ – not thriving. The reason isn’t access to food. It’s whether they still have a reason to bother. For 20%, better awareness and access to simple information is also likely to be helpful.
While innovation and services have focused almost exclusively on prepared meals as the solution, HomePlate Insights suggests other barriers matter just as much.
Hidden warning signs
- Cooking for one is the tipping point. Almost a quarter of those interviewed one-on-one were living or eating alone, and 40 per cent of people living alone say cooking for one is simply unappealing – the single biggest barrier to eating well in that group.
- ‘It’s just me, it doesn’t matter anymore.’ After losing a partner, motivation to cook can disappear almost overnight. One in nine people interviewed directly linked their declining eating habits to the loss of a spouse.
- More than a quarter are quietly skipping meals. Lunch is often the first meal to go, replaced by a cup of tea and a biscuit.
- Confidence masks risk. Nearly 8 in 10 older people rate their eating as ‘good’ or ‘excellent’ – but of those, more than half (53 per cent) already have at least one risk factor – living alone, financial strain, or being 85+ – that puts their future eating quality in jeopardy.
- It gets worse with age. Just 30 per cent of people aged 85+ say they still enjoy cooking and feel confident doing it, down from around half of those aged 65-74.
A proportion of older people lack awareness about the importance of, and give too little priority to, good food.
Why this matters
Malnutrition among older people living independently is estimated at around 5 per cent, but that figure climbs to 30-40 per cent among those admitted to hospital. Unlike a dramatic health event, malnutrition in older age typically builds quietly, meal by missed meal, until it surfaces as a fall, an infection, a wound that won’t heal, or a hospital admission.
‘Older people overwhelmingly want to grow old at home. But staying at home and staying well aren’t always the same thing,’ says Maggie Beer Foundation CEO, Jane Mussared.
‘Malnutrition can build slowly and quietly, and it often goes unnoticed until someone ends up unwell. We created HomePlate because we wanted to find out from older people what their experiences are. We want to work with older people, aged care colleagues, foodies, clinicians and others to address the barriers to eating well.
‘We need to understand the opportunities that might help an older person stay well at home, before health crises make it too late.’
It’s not about food access – it’s about wanting to bother
The research suggests there’s real opportunity in widening the focus of nutrition for isolated elders, beyond food delivery. The single strongest driver of poor eating outcomes is a lack of energy or motivation – it is more than twice as influential as the cost of food.
The strongest driver of good eating is anticipation and enjoyment of food – nearly three times more powerful than any other factor measured. Sharing meals with others is directly linked to both higher enjoyment of food and significantly higher overall wellbeing.
Simple clear information about food, and support about how to prepare it, is likely to be valued by older people. ‘What the academic literature confirms is what we heard directly from older people themselves, that malnutrition in later life is rarely dramatic, and rarely about a single cause,’ said Professor Susan Kurrle, from University of Sydney.
‘It’s the slow accumulation of physical changes, social isolation and lost confidence in the kitchen, and it’s still under-recognised in how we support older people to live well at home. This review brings together Australian and international research to make the case clearly: food is not incidental to healthy ageing, it’s central to it.’
The company gap
Eating with others is one of the most powerful things that keeps older people eating well, but many are missing out on it. In the national survey, 18 per cent of older people rarely or never share a meal with anyone, rising to more than a third of those who live alone.
Almost half of all people living alone say they would like to share meals more often than they currently do.
In one-on-one interviews conducted as part of the qualitative research, the sentiment came through again and again, in older people’s own words:
‘If I’m on my own, I don’t bother.’ — Focus group, Yamba, NSW
‘When you eat with other people, you always eat more.’ — Coffee group, Albury, NSW
‘It’s the company that matters.’ — Focus group, Rochester, VIC
A reason to eat
The research found that current support for older people is heavily skewed toward food provision – meal delivery services like Meals on Wheels are well known and valued – but almost 8 in 10 people surveyed could not name a single initiative that helps with the other things that get in the way of eating well: motivation, cooking confidence, or social connection around food.
Encouragingly, those experiencing the poorest eating outcomes are the most open to trying something new, pointing to new opportunities.
‘This research gives us something we’ve never had before – a clear, evidence-based picture of what’s really getting in the way of older people eating well at home,’ said Clare Fargher, HomePlate Project Lead.
‘It tells us that we need to focus on building motivation, confidence in the kitchen, and connection at the table. The Maggie Beer Foundation will work with stakeholders in the next stage of the HomePlate Project to explore and address these gaps.’
