Health policy (Amsterdam, Netherlands) · 2026
Dietitians Role in Long-Term Care Homes: A Cross-Country Analysis of Legislation, Standards, Guidelines, and Role Statements.
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Bartrim Karly, Messiter Amelia, Barr Nicole, Ball Lauren, Cave Danielle, Olufson Hannah, Lepre Breanna, Wheeler Mikaela, Pashley Alice
Аннотация
BACKGROUND: Dietitians play an important role in improving residents' health and quality of life in long‑term care (LTC) homes. However, dietitians' global role is not well understood.
OBJECTIVE: To explore the role and involvement of dietitians in LTC homes globally, according to legislation, standards, guidelines and role statements.
METHODS: A cross-sectional document and website analysis was conducted. Countries listed on international dietetic websites were included, with documents eligible if dietitians were referenced in legislation, guidelines, or standards, or if role statements focused on LTC homes. Data were analysed using descriptive statistics, qualitative content analysis and quantitative comparative analysis.
RESULTS: Sixty-eight countries were identified, of which 37 (54%) had at least one document type. Role statements (n=28) were the most common type, followed by standards (n=10), legislation (n=8) and guidelines (n=6). Japan was the only country with all document types, followed by Australia, Türkiye and Northern Ireland with three. Fourteen core topic areas were identified; dietitian services, nutrition care plans, nutrition support, malnutrition screening/diagnosis, food provision, menus, foodservice management, mealtime experience/dining environment, multidisciplinary collaboration, staff training, compliance, developing documents, quality improvement projects and committee involvement.
CONCLUSION: Dietitian roles in LTC homes differ globally, reflecting variations in policy and practice. Many countries lack formal guidance, while others provide detailed frameworks. These disparities are shaped by demographic, cultural, systemic, economic and workforce factors that influence how LTC is structured. Stronger international coordination and national advocacy are needed to improve recognition of dietitians' roles and guide future policy supporting high-quality resident nutrition care and foodservice systems.
OBJECTIVE: To explore the role and involvement of dietitians in LTC homes globally, according to legislation, standards, guidelines and role statements.
METHODS: A cross-sectional document and website analysis was conducted. Countries listed on international dietetic websites were included, with documents eligible if dietitians were referenced in legislation, guidelines, or standards, or if role statements focused on LTC homes. Data were analysed using descriptive statistics, qualitative content analysis and quantitative comparative analysis.
RESULTS: Sixty-eight countries were identified, of which 37 (54%) had at least one document type. Role statements (n=28) were the most common type, followed by standards (n=10), legislation (n=8) and guidelines (n=6). Japan was the only country with all document types, followed by Australia, Türkiye and Northern Ireland with three. Fourteen core topic areas were identified; dietitian services, nutrition care plans, nutrition support, malnutrition screening/diagnosis, food provision, menus, foodservice management, mealtime experience/dining environment, multidisciplinary collaboration, staff training, compliance, developing documents, quality improvement projects and committee involvement.
CONCLUSION: Dietitian roles in LTC homes differ globally, reflecting variations in policy and practice. Many countries lack formal guidance, while others provide detailed frameworks. These disparities are shaped by demographic, cultural, systemic, economic and workforce factors that influence how LTC is structured. Stronger international coordination and national advocacy are needed to improve recognition of dietitians' roles and guide future policy supporting high-quality resident nutrition care and foodservice systems.