Nutrition Services for Older Adults in Long-Term Care, Post-Acute and Other Settings: Updated Position of Academy of Nutrition and Dietetics

April 5, 2018

CHICAGO – The Academy of Nutrition and Dietetics has published an updated position paper that highlights the importance of individualized nutrition care, provided by registered dietitian nutritionists, for the increasing number of older adults who receive health care in long-term, post-acute and other settings.

According to the Academy's position paper "Individualized Nutrition Approaches for Older Adults: Long-Term Care, Post-Acute Care and Other Settings," which has been published in the April issue of the Journal of the Academy of Nutrition and Dietetics:

It is the position of the Academy of Nutrition and Dietetics that the quality of life and nutritional status of older adults in long-term care, post-acute care and other settings can be enhanced by individualized nutrition approaches. The Academy advocates that as part of the interprofessional team, registered dietitian nutritionists assess, evaluate and recommend appropriate nutrition interventions according to each individual’s medical condition, desires and rights to make health care choices. Nutrition and dietetics technicians, registered assist registered dietitian nutritionists in the implementation of individualized nutrition care, including the use of least restrictive diets.

Post-acute care refers to skilled nursing care and therapy provided after an inpatient hospital stay. Malnutrition, weight loss, poor food intake, food satisfaction and acceptance are serious issues in the older population, according to the Academy's position paper.

A recent systematic literature review showed that 47% to 62% of older adults in long-term care are at risk for malnutrition, which can lead to a loss of strength and function, increased risk of falls, depression, lethargy, immune dysfunction, increased risk of infection, delayed recovery from illness, pressure injuries, poor wound healing, increased chance of hospital admission and readmission, increased treatment costs and a greater risk of death.

One estimate revealed that 50% to 70% of nursing home residents leave more than a quarter of their food uneaten, according to the position paper.

"Food is an essential component of quality of life," said registered dietitian nutritionist and Academy Spokesperson Angel Planells. "Including older adults in decisions about their food can improve their desire to eat and improve their overall health and well-being."

"Maximizing food intake can help prevent malnutrition and unintentional weight loss, which can lead to additional health complications," Planells said. "Registered dietitian nutritionists can help by recommending appropriate nutrition interventions based on each older adult's needs and preferences."

The Academy's position paper was written by Becky Dorner, RDN, LD, FAND; and Elizabeth K. Friedrich, MPH, RDN, CSG, LDN, FAND, NWCC.


The Academy of Nutrition and Dietetics is the world's largest organization of food and nutrition professionals. The Academy is committed to improving the nation's health and advancing the profession of nutrition and dietetics through research, education and advocacy. Visit the Academy at