According to the UnitedHealth Foundation, more than 55.8 million adults ages 65 and older live in the U.S., accounting for nearly 17 percent of the nation's population. By 2040, that proportion is projected to grow to 22 percent.1 With such a large sector of the population approaching their golden years, health issues requiring nutritional intervention are increasing as well.
The model for nutrition management and dietary support in senior living communities is approaching a critical impasse. In fact, with demand steadily increasing, macro labor trends indicate that traditional registered dietitian (RD) staffing models will not be able to meet market requirements. And the pressure of the current labor crisis for nutrition professionals is not a short-term situation.
The number of enrolled students in dietetic programs is decreasing year over year,2 while job growth is expected over the next decade. Coupling this data indicates an astounding 20.5 percent workforce gap. And this growing gulf isn’t just among RDs; the story is the same across the entire spectrum of the dietary profession. Competition to attract and retain talent is at an all-time high, and there are numerous industries all fishing from the same shrinking pond.
Change Is Coming
The traditional path to becoming a registered dietitian includes earning a bachelor’s degree, completing at least 1,000 hours of supervised practice, and passing the national registration examination. Once these pre-requisites are attained, RDs must follow state-specific guidelines and stay up to date in dietetics through continuing education. For RDs choosing to build their careers in geriatrics, they can expect to manage 75-300 or more residents each month, depending on the facility, acuity level, budget, and total community population.
As the field of nutrition and dietetics continues to evolve, so too do the requirements for registration. Effective January 1, 2024, aspiring RDs will face a significant change as the minimum degree requirement for eligibility to take the registration exam will change from a bachelor’s degree to a graduate degree. This shift reflects the increasing complexity of the profession, and the growing recognition of the critical role dietitians play in supporting senior health.
The Commission on Dietetic Registration (CDR) is the credentialing agency for the Academy of Nutrition and Dietetics and maintains a registry of over 115,000 credentialed practitioners. According to the CDR, the decision to change the degree requirement for RDs was based on recommendations from the Council on Future Practice Visioning Report (2012).
“Almost all other health care professions have increased entry-level educational standards beyond bachelor's degrees. Elevating the entry-level RD education to a graduate level is consistent with the knowledge, skills, and research base required in the field of nutrition and dietetics.”3 Although the transition will present challenges, it also opens new opportunities for advanced knowledge, specialization, and research.
The Impact on First-Timers
Fortunately for established practitioners, only those seeking eligibility to take the dietitians’ registration exam for the first time will be required to complete a graduate degree from an accredited university (i.e., a master’s degree, practice doctorate, or doctoral degree). For students seeking a master’s in nutrition, this could mean an additional $9,000-50,000, depending on the program.4
There are five different paths a prospective RD can take to establish his/her eligibility. The programs themselves vary, but the core of the training is consistent: in addition to a degree, each includes mandatory coursework and at least 1,000 hours of experiential learning or supervised practice, which typically takes 6 to 12 months.
Individuals who establish eligibility for the exam by the end of 2023 will not be required to obtain a graduate degree. (Note they don’t have to take the exam by January 1, 2024, but they must establish eligibility.) All other entry-level dietitian registration eligibility requirements remain the same.
Once registered, dietitians maintain their growth and development through continuing education and specialty certifications. Advanced credentials in geriatrics, diabetes, renal, obesity, and dementia are common among RDs practicing in senior living communities.
Industry Impact Remains To Be Seen
Progressing toward a career as a registered dietitian seems straightforward, yet the looming question is less around “how to meet new requirements” and more around “how will changes impact the field in a practical sense?” Many dietetic and HR managers in the senior living industry are concerned.
By extending education requirements, new RD recruits will be slower to market, at least at first. This new standard will increase the timeline to registration eligibility from 5 years to an average of 6.5 years. Essentially, a gap will be created between when the graduate degree requirement is implemented and when these new students will be ready for employment. The additional time and resources required to obtain a graduate degree may be prohibitive to some, thus decreasing the pool of new professionals at a time when the need for RDs in senior living is greater than ever. Remember that 20 percent gap? Who will fill that?
Higher education levels typically mean higher salaries, but many communities are struggling financially already—will they be able to afford these higher-priced dietitians? And if fresh-out-of-school dietitians are commanding more money, what does this mean to RDs who have been faithfully working for years at a lower salary?
These questions and more will likely remain unanswered for years, but one tenet is clear: RDs are among the most educated healthcare professionals in senior living communities, and the smartest administrators are those who take advantage of this knowledge to maximize the value a dietitian adds to residents’ lives.
References
1. “America’s Health Rankings.”UnitedHealth Health Rankings, https://www.americashealthrankings.org/explore/measures/pct_65plus. Accessed June 5, 2023.
2. The Accreditation Council for Education in Nutrition and Dietetics (ACEND), ACEND Program Enrollment and Trends report. Program Enrollment Trends.pdf (eatrightpro.org) Accessed June 28, 2023.
3. “2024 Graduate Degree Requirement – Registration Eligibility.” Commission on Dietetic Registration, https://www.cdrnet.org/graduatedegree. Accessed June 6, 2023.
4. College Hippo, https://www.collegehippo.com/. Accessed June 6, 2023.
Tracy Blazer is the regional vice president, west/midwest region, at Sodexo Seniors. She is a registered dietitian with a master’s degree in public health nutrition and has been a nutrition professional in the senior living segment for more than 20 years.