This study aimed to elicit concerns of key stakeholders regarding foodservice provision for long-stay hospital patients. Seventeen focus groups and four individual interviews were conducted involving six stakeholder groups: dietitians, nutrition assistants, patients, nurses, foodservice assistants and foodservice managers. Ninety-eight participants (20 male, 78 female) were recruited from public and private hospitals in New South Wales, Australia. Each of the focus groups and individual interviews was conducted in a hospital setting where free and open discussions could be digitally recorded. Transcripts were prepared from the digital recordings and QSR Nvivo 2.0 qualitative analysis software (QSR International, Melbourne, Australia) was used to code the transcripts prior to content and thematic analysis. Themes were identified by relative frequency in the discussion, number of issues raised within each theme and the importance placed on the issues raised. Five major themes emerged from 37 discussion topics: the foodservice system, menu variety, preparation to eat and feeding assistance, packaging and portion size. Participants were particularly concerned about the increased packaging of food products, perceived lack of meal set up and feeding assistance, limited menu variety especially when considering longer stay hospital inpatients, and the increased use of cook-chill operations. These findings lend themselves well to testing in a wider sphere via quantitative means in a proposed national survey. The results of this survey may produce a position on the main barriers to effective foodservice provision for long-stay patients in the Australian context, and enable identification of practical solutions.

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Dementia is a common syndrome in older people. Dementia alters eating behaviors, hunger and thirst cues, swallow function, ability to self-feed, and recognition and interest in food. There is significant variation in the reported prevalence of malnutrition among older people who live in long-term care. The aim was to conduct a systematic literature review and meta-analysis of the prevalence of malnutrition in those with dementia living in long-term care using a validated nutrition assessment tool. Scopus, Web of Science, CINAHL, and Medline were searched. A random effects model was used to determine the prevalence and risk of malnutrition. Data were retrieved from 24 studies. Most of the studies were from Europe or South Asia. The prevalence of malnutrition ranged from 6.8 to 75.6%, and the risk of malnutrition was 36.5–90.4%. The pooled prevalence of malnutrition in those with dementia in long-term care was 26.98% (95% CI 22.0–32.26, p < 0.0001, I2 = 94.12%). The pooled prevalence of the risk of malnutrition in those with dementia was 57.43% (95% CI 49.39–65.28, p < 0.0001, I2 = 97.38%). Malnutrition is widespread in those with dementia living in long-term care. Further research exploring malnutrition in other industrialized countries using validated assessment tools is required.

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