Eating for health: Older adults in care homes

All residents who are identified as malnourished or at risk of malnutrition should receive the following 'Food First' treatment every day, in addition to a balanced menu where possible, to help increase their intake:

  • 1 pint of fortified whole milk per day
  • 2 nourishing snacks or drinks a day
  • 3 fortified meals every day.

Fortified milk

1 pint whole milk (375 Kcals, 19g protein, 670mg calcium) + 4 tablespoons of skimmed milk powder = 1 pint of fortified milk (580Kcals, 40g protein, 990mg calcium).

Fortified milk can be used in drinks, on cereals or in some of the fortified recipes. See recipes below for more ideas. For residents requiring dairy free alternatives, please contact your dietitian for advice.

Nourishing snacks and drinks

In addition to three smaller meals, offering 2-3 nourishing snacks or drinks per day between meals can significantly improve intake.

Some residents find it difficult to sit through meals or are constantly active throughout the day either due to dementia or anxiety. These residents are at increased risk of malnutrition.  Providing finger foods throughout the day enables residents to feed themselves.

Nourishing drinks include fortified milk (hot or cold), hot chocolate, coffee or malted drinks made with fortified milk, homemade milkshakes and smoothies. Readymade milkshakes*, drinks and smoothies, such as Frijj, Mars or Yazoo, are available in most supermarkets and convenience stores and can be included as a nourishing drink too.

Equivalent to 4 plain biscuits

Aim for a nourishing snack mid-afternoon & evening everyday

Ideas for nourishing snacks and finger food:

  • Fruit cake                                                                          
  • Toasted teacake or scone with butter & jam
  • Sandwich triangles                                                     
  • Breakfast cereal & enriched milk                           
  • Soup with bread and butter               
  • Tea bread or malt loaf with butter & cheese                 
  • Crackers with butter & cheese                                
  • Toast with peanut butter or cheese
  • Nuts with dried fruit                               
  • Pizza fingers
  • Cheese cubes
  • Toasted crumpets with butter
  • Fruit pieces & cream
  • Gingerbread

Fortified meals

A fortified diet is achieved by fortifying at least one dish at each mealtime to make it more nutrient dense. The following foods can be used to easily fortify meals. Ensure you have a supply of the following ingredients.

Ingredient

How to use

Additional calories and protein

Milk powder

Add 4 tablespoons of whole milk powder to 1 pint of full cream milk to make fortified milk, use this for milk drinks, porridge, sauces & on cereals. Use to make up instant soups, porridge and jelly instead of water.

1 tbsp

55 Kcals, 5.5g protein

Whole milk

Use to make up instant soups, porridge and jelly instead of water. For extra calories and protein use fortified milk.

1/3 pint fortified milk 
180 Kcals, 23g protein

Evaporated or condensed milk

Use in place of usual milk to prepare porridge and milk puddings or add 2 tablespoons to individual portions when porridge /milk puddings are served.

2 tbsp

51 Kcals, 2g protein

Double cream

Add 2 tablespoons to each serving of porridge, soup and dessert or fruit.

2 tbsp

130 Kcals

Cheese

Sprinkle 2 tablespoons grated cheese onto soups, stews, sauces, potatoes, vegetables and scrambled eggs.

2 tbsp
125 Kcals, 7g protein

Margarine/ butter

Use 1 teaspoon extra butter/margarine on bread / crackers, 2 teaspoons to each serving of potatoes and vegetables.

2 tsp margarine             80 Kcals

Nut butters/ Ground almonds

Add to porridge or soups, mix ground almond into stews or casseroles

1 tbsp
95 Kcals, 2-3g protein

Sugar*

Use at least 1 extra teaspoon of sugar on cereals/ porridge and added to desserts

1 tsp sugar
24 Kcals

Jam, honey, syrup*

Spread thickly on bread/ toast. Serve milk puddings with 2 teaspoons of jam or honey. Serve porridge with 2 teaspoons honey or syrup.

2 tsp jam
32 Kcals
 

Fortified drinks recipes

Milkshake*

Juice*

Soup

Ingredients:

200mls whole milk

1 scoop of ice cream

2 tbsp skimmed milk powder

3 tsp vitamin fortified milkshake powder, such as Nesquik or Tesco Milkshake Mix

Method:

Add all the ingredients together and whisk.

Serve chilled or warm.

Calories: 399

Protein: 19.9g

Ingredients:

100mls fresh fruit juice

100mls lemonade

1 scoop ice cream

1 tbsp sugar

Method:

Mix all the ingredients together.

Serve chilled.

Calories: 192

Protein: 2.3g

Ingredients:

1 instant soup sachet

200mls full fat milk

2 tbsp skimmed milk powder

Method:

Warm the milk.

Gradually add the soup sachet and milk powder, stirring well.

Calories: 351

Protein:19g
 

Abbreviations: tsp = teaspoon   tbsp = tablespoon   mls = millilitres

*May not be suitable for residents who have diabetes, discuss with a Dietitian, Diabetes Specialist Nurse or GP.

If you would like this information in another format, for example large print or easy read, or if you need help communicating with us, please contact:

First Community (Head Office)

Call: 01737 775450 Email: fchc.enquiries@nhs.net Text: 07814 639034

Address: First Community Health and Care, Consort House, 5-7 Queensway, Redhill, Surrey, RH1 1YB.

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For office use only: Version 3 HPD_TS027 Publication date: May 2026