One thing we seem to do very well in Scotland is to produce well written legislation and policy intervention perhaps with the recent exception of the National Care Service Bill! Our problem is always in the poor implementation!
Another thing we do well is food and drink. As a nation we have a rich culinary heritage with world-class produce respected the world over. Food is woven into the very fabric of who we are.
An example of good legislation and progressive policy is the Good Food Nation Act which became law in 2022. Yet here too despite the aspiration there are very real concerns about its implementation, not least when it comes to older people – particularly those receiving care at home or in care homes.
This coming week is Nutrition and Hydration Week, with its annual focus on the criticality of both for all our health and wellbeing. For me the week and indeed the potential of the Good Food Nation Act poses some hard questions. Are we truly doing enough to ensure that every older person in Scotland, regardless of where they live, has access to nutritious, enjoyable, and culturally appropriate food? Do we see mealtimes as a moment of dignity, connection, and pleasure – or simply as another task to be ticked off? And as Scotland moves forward with the Good Food Nation Act, are we making sure that older people – who are too often invisible in food policy – are placed at the heart of the conversation?
Because let’s be honest: malnutrition and dehydration in older age are not just clinical issues. They are issues of human rights, dignity, and quality of life. Critically we too often overlook the most basic truth: good food is fundamental to good care.
For many older people in Scotland, food is a source of joy, tradition, and memory. But for too many, it has become a daily struggle.
In care homes, stretched staffing means that mealtimes can become rushed, reducing what should be a moment of social interaction to an exercise in efficiency. The challenges of chewing, swallowing, and declining appetite are not always given the attention they deserve. Too often the amount we allocate financially to the purchase of food as a State when we buy care packages is grossly inadequate. I am not at all convinced that as a society we are paying care providers an adequate amount to ensure appropriate nutrition.
For those receiving care at home, the situation can be even more precarious. Many older people in the community live alone, with limited mobility, making it harder to shop, cook, or even remember to eat and drink. Homecare workers – already pressed for time – may have only minutes to prepare a meal, leaving little opportunity for encouragement, companionship, or the careful support some people need to eat well.
And at a policy level, food and drink are too often treated as afterthoughts in social care planning rather than as core elements of wellbeing. We have guidance. We have frameworks. But what we lack is a joined-up, rights-based approach to food in care and support – one that ensures no older person is left behind when it comes to good nutrition.
Scotland’s Good Food Nation Act is a landmark piece of legislation. In the words of the quite excellent Scottish Food Coalition it is ‘ a groundbreaking piece of legislation that requires Scottish Government to think about food as an interconnected system. However, legislation alone will not create the changes we need to see.’
We see that in the failure to tie down the right to food as an explicit human right with all that entails were it to be incorporated into Scottish law. It is as the Coalition argues also critical that resource and support is given to make those on the ground achieve the aspirations of the legislation.
If the vision of the Good Food Nation Act is to become a reality, older people’s food needs must be fully recognised in every part of its implementation and that sadly to my mind is simply not happening.
This means that care homes and homecare services must be included in national and local food planning. It means social care providers must be given the resources – not just guidance – to improve food provision. It means care workers must be trained and empowered to support nutrition and hydration, recognising these as essential, not optional, parts of their role. And critically, it means that older people themselves must be heard. A Good Food Nation cannot ignore those who rely on social care.
If we are serious about tackling malnutrition and dehydration among older people in Scotland, then we need to move beyond words and into action.
We need to see better funding and training for care staff. Homecare workers, in particular, must have the time and skills to support people with eating and drinking. You cannot do that in the increasing number of commissioned 5- or 15-minute visits.
The Good Food Nation Act underlines that the right to food is a human right. But for that to be more than words it means that every older person, whether in a care home or at home, should have access to nutritious, appealing food that meets their personal and cultural needs.
Nutrition and Hydration Week is an opportunity to shine a light on these issues, but the conversation must not end here. The Good Food Nation Act gives us a once-in-a-generation chance to make food a true priority in social care.
Good food is not just about nutrients. It is about dignity, joy, and human connection. And no one – no matter their age, their health, or their circumstances – should be denied that.
As the American First Nation poet Joy Harjo says food and nutrition are not just about substance they shape our world and that is as much about older age as any age. Her poem is ‘Perhaps The World Ends Here’
The world begins at a kitchen table. No matter what, we must eat to live.
The gifts of earth are brought and prepared, set on the table. So it has been since creation, and it will go on.
We chase chickens or dogs away from it. Babies teethe at the corners. They scrape their knees under it.
It is here that children are given instructions on what it means to be human. We make men at it, we make women.
At this table we gossip, recall enemies and the ghosts of lovers.
Our dreams drink coffee with us as they put their arms around our children. They laugh with us at our poor falling-down selves and as we put ourselves back together once again at the table.
This table has been a house in the rain, an umbrella in the sun.
Wars have begun and ended at this table. It is a place to hide in the shadow of terror. A place to celebrate the terrible victory.
We have given birth on this table, and have prepared our parents for burial here.
At this table we sing with joy, with sorrow. We pray of suffering and remorse. We give thanks.
Perhaps the world will end at the kitchen table, while we are laughing and crying, eating of the last sweet bite.
From https://www.poetryfoundation.org/poems/49622/perhaps-the-world-ends-here
Donald Macaskill
Photo by Annie Spratt on Unsplash
