In January 2022, the investigative book The gravediggers, by Victor Castanet (Fayard editions), on nursing homes, caused a stir. Several private groups like Orpea or Korian were then singled out for mistreatment and deprivation of care. But in this work, it was also about malnutrition. In its issue which comes out this Thursday, the magazine 60 Million consumers looked into this issue of meals in nursing homes. “Feeding residents poorly is a form of mistreatment,” says Patricia Chairopoulos, head of the food section at 60 Million consumers.
More than 250 nursing home residents, aged 70 to 103, as well as their loved ones, responded to an online questionnaire*. Among them, many testimonies from caregivers desperate to see their loved ones die. “Unlike students in school canteens, nursing home residents eat there at every meal,” recalls the journalist. Whether it concerns the sad contents of the plates, the meal times sometimes too far apart or the lack of help at the table, the observation is considered “distressing and worrying”. 20 minutes gives you the four pieces of information to remember.
Unappetizing meals
“Inedible mush”, “unidentifiable food”, “unappetizing”, “without any taste”… This is how residents and their relatives describe the meals served in nursing homes. Journalists also received numerous “distressing” photos of meal trays. “There is a real gap between the menus displayed and reality,” notes the section manager. If we rely on the displayed menu to make a nutritional assessment, it is wrong. »
Due to lack of resources, nursing homes do not personalize meals. “Everyone should, depending on their pathology, their metabolism and their desires, have a different menu,” believes Patricia Chairopoulos. In her investigation, the journalist realized that in certain establishments, all residents received fully mixed meals, even those with no swallowing problems. “It is very badly experienced by residents who do not need it. »
Unfinished plates
As a result of these low-end meals, residents eat less than necessary. Only one in four finishes their plate at each meal, while one in two finishes it “sometimes”, and one in five never. However, as Annick Ruffat, dietician in Luchon hospitals, recalls in the survey, “contrary to popular belief, aging increases energy needs, due to poorer metabolic performance”.
By eating less, one in three residents suffer from malnutrition. A condition which is not always identified in time by staff. Because, as the survey shows, only 38% of people living in nursing homes are weighed once a month. “By not weighing them, the staff often notices too late that they have lost weight, which makes it difficult to return to good physical shape,” considers Patricia Chairopoulos. Because weight loss leads to a loss of muscle mass, a loss of energy, a decline in cognitive abilities, an increase in the risk of falls and, ultimately, malnutrition with risks of nosocomial diseases.
Too long a fast
Another downside: the time slot between dinner and breakfast the next day would be too long. The survey reveals that in 75% of cases, it exceeds twelve hours. Or more than the maximum fasting recommended by geriatricians turns out to be exceeded. “Prolonged fasting is not good for an already weakened body,” comments the journalist.
A lack of help at the table
Finally, last problem, and not the least, the lack of staff. The article shows that in only a third of cases, a person is present throughout the meal. A level of support deemed “too low compared to needs”, particularly for residents with motor skills problems. “Some of the residents are forced to wait a long time at the table before being able to eat. As a result, the dishes are cold and people therefore have less desire to eat them. ” A vicious circle.
*Qonline questionnaire completed by 255 people between June 6 and August 16, 2023. Journalists also received around fifty menus and/or photos of meals.