Adjusting to Mealtime Change within the Context of Dementia

Abstract

Little is known about how persons with dementia and their care partners respond to mealtime changes that occur throughout the dementia journey. By interviewing 27 persons living with dementia and their 28 care partners, we explored the meaning and experience of change surrounding mealtimes. Participants adjusted to mealtime change by adapting to an evolving life, as a result of a dynamic process of becoming aware of change, attaching meaning to change, and responding to change. Seminal events compounded by a sense of things being different triggered awareness of mealtime changes. Meaning was attached to mealtime changes, observed through emotions experienced and diverse strategies developed to support mealtime values. Responding to change ranged from resisting, to being in a holding pattern, to transforming and adapting. Understanding how individuals and families adjust to mealtime changes, and the strategies they develop, provides critical insights for supporting families throughout the dementia journey.

Strategies to support engagement and continuity of activity during mealtimes for families living with dementia; a qualitative study

“…The objective of the Eating Together study [36–38] was to uncover the meaning of the mealtime experiences of persons living with dementia and their primary family care partners. Longitudinal data collection allowed us to understand what was truly meaningful for dyads as dementia progressed and transitions to formal care settings occurred.…”

A recipe for mealtime resilience for families living with dementia

“…The Eating Together study (11)(12)(13) provided a unique opportunity to explore the topic of resilience in families living with dementia, specifically using the context of mealtimes. A strength of the narrative perspective used in this study was the ability to analyse in depth a single dyad's experiences longitudinally, noting the ebb and flow of participants' resilience as they encountered obstacles (20,24).…”

“…Researchers realign memories of past and current experiences, foreshadow the future, and interpret different aspects of the lived experience (25). From the initial 27 families of the Eating Together Study (11)(12)(13), one dyad that participated for 6 years was chosen for this analysis, as they were an example of resilience and adaptation while living with the continual changes seen with dementia. In keeping with the goal and the narrative methodology of this study, this single purposively chosen dyad allowed for in-depth, rich analysis (24).…”

“…Digital recordings were transcribed verbatim. The purpose of the Eating Together study was to develop a substantive theory on the meaning and experience of mealtimes for families living with dementia; further details on methods can be found in prior reports (11)(12)(13). Ethics review and clearance for the Eating Together study (REB #04NV007) and this specific narrative analysis (REB #11AP05) was provided by the University of Guelph.…”

“…In fact, 'mealtimes mirror the way we are' suggesting that mealtime experiences reflect various aspects of living with dementia, including experiencing satisfaction when meeting the challenges associated with the changes experienced (11,12). Emotions experienced and strategies developed also suggest that meanings are attached to mealtime changes and families adapt to support mealtime values (13). Yet, the extent of adaptation and resilience of these families has not been fully appreciated until our research uncovered their hidden strengths.…”