We check the menu every year. We never check the person.
On Tuesday 22 September I gave evidence to the Senate inquiry into the Support at Home Program in Canberra. I was there for one reason: nothing in Support at Home requires anyone to check whether an older person living at home is eating enough.
I pressed one recommendation. Require every Support at Home provider to screen every client for malnutrition risk: when they start, at least once a year, and after a hospital stay.
“The rules require a provider to know what a client likes to eat. Nothing requires anyone to check whether the client is actually eating it. We check the menu every year. We never check the person.”
How big is the problem?
Around one in three older Australians receiving home care are at risk of malnutrition, and close to one in ten are already malnourished. That is 42 per cent in all.
Our own screening finds about 46 per cent. As I told the committee, that is slightly higher than the published figure, and people who come to us are more likely to already suspect a problem. But it points the same way.
The Department told the committee there were about 390,000 people on Support at Home at 30 June. At those rates, that could be around 160,000 older Australians who are malnourished or at risk. That is our estimate of the scale, not a measured count. No national count exists, because no one is required to look.
Malnutrition is not just about weight. It means falls, hospital stays and an earlier move into residential care. The Australian Commission on Safety and Quality in Health Care puts each episode of malnutrition acquired in hospital at about three extra weeks in hospital and about $44,000.
Why it goes unnoticed
When someone first enters Support at Home, the assessment has very little to say about nutrition. As I put it to the committee: “The entry assessment comes down to one nutrition question: have you lost weight? Nothing has to happen when the answer is yes. After that nobody looks again.”
Weight loss is often slow and easy to miss, especially for someone living alone. Appetite drops after an illness, a new medication or a hospital stay. By the time anyone notices, strength has already been lost. Asked by Senator Anne Ruston how well nutrition risk is understood and managed under the assessment system, my answer was plain: “I don’t think it’s very well managed or identified at all.”
Not another job for providers
Providers have told the same inquiry they are stretched, and that the 10 per cent allowed for care management is not enough. I told the committee I was not asking to add to that load.
Malnutrition screening is clinical care, and it can be light. The screen is a short questionnaire. Many older people or their families can complete it themselves, and those who need help can be supported through it.
We are not alone in asking. Dietitians Australia’s submission to the inquiry also calls for universal malnutrition screening for people on Support at Home.
The money is already there
This change needs no new money. A dietitian and prescribed nutrition support are already on the Support at Home service list as clinical supports, with no contribution from the older person, subject to the provider approving them. As I told the committee: “That funding is there to be used. What is missing is the requirement to look.”
Our interest, stated plainly
Eat Well Health is paid for its products and services, and I declared that to the committee. But the recommendation does not depend on us. As I said on the day: “I’m asking you to require the screening, not our tool.”
The committee reports to the Senate on 24 November 2026. The hearing video, the transcript and every submission are on the committee’s website.
What you can do now
If you are a Support at Home provider or care manager: your clients can complete our nutrition screen at no charge, online or in our app, and with their consent the result comes to you. Get in touch to register so results reach the right person.
If you are on Support at Home, or caring for someone who is: complete the nutrition screen. If you have noticed weight loss, a smaller appetite or less strength, raise it with your care manager or your doctor and ask whether a dietitian should see you.
Quotes are from the proof transcript of evidence, Senate Community Affairs References Committee, Inquiry into the Support at Home Program, Canberra, 22 September 2026. Andrew Martin is Director of Eat Well Health, which is paid for nutrition screening, dietitian services and nutrition support products.