Attitudes, perceptions and experiences of mealtimes among residents and staff in care homes for older adults: A systematic review of the qualitative literature

Abstract

Addressing problems associated with malnutrition in care home residents has been prioritized by researchers and decision-makers. This review aimed to better understand factors that may contribute to malnutrition by examining the attitudes, perceptions and experiences of mealtimes among care home residents and staff. Five databases were searched from inception to November 2015: Medline, Embase, PsychINFO, AMED, and the Cochrane Database. Forward and backward citation checking of included articles was conducted. Titles, abstracts, and full texts were screened independently by two reviewers and quality was assessed using the Wallace criteria. Thematic analysis of extracted data was undertaken. Fifteen studies were included in the review, encompassing the views and opinions of a total of 580 participants set in nine different countries. Four main themes were identified: (1) organizational and staff support, (2) resident agency, (3) mealtime culture, and (4) meal quality and enjoyment. Organizational and staff support was an over-arching theme, impacting all aspects of the mealtime experience. Mealtimes are a pivotal part of care home life, providing structure to the day and generating opportunities for conversation and companionship. Enhancing the mealtime experience for care home residents needs to take account of the complex needs of residents while also creating an environment in which individual care can be provided in a communal setting. PROSPERO Registration: CRD42015025890.

Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term care

“…Mealtimes have the potential to foster and support important and meaningful social relationships over the life course [ 1 , 2 ]. Consequently, food and mealtimes are considered key aspects of quality of life and satisfaction for residents living in long-term care (LTC) homes [ 3 – 5 ]. Specifically, mealtimes in LTC have the capacity to act as a starting point for creating and sustaining social relationships [ 6 ].…”

Eating well in care homes: Testing the feasibility of a staff training programme aimed at improving social interaction and choice at mealtimes

“…Building on the findings of our qualitative systematic review of mealtime experiences (Watkins, Goodwin, Abbott, Backhouse, et al, 2017a), a resident interview study (Watkins, Goodwin, Abbott, Hall, et al, 2017b) found that the socio-cultural context of mealtimes, that is, resident interactions, choice and independence, had a profound influence on the dining experience. The existing model of care provision may have a negative effect on mealtimes because resident choice is limited, independence is curbed, and social interaction stifled due to the paternalistic tendencies of staff, and time and/or resource pressures, that result in staff being task-rather than resident-focussed (Reimer & Keller, 2009).…”

“…The intervention was based on the findings of two precedent studies (Watkins, Goodwin, Abbott, Backhouse, et al, 2017a;Watkins, Goodwin, Abbott, Hall, et al, 2017b) and the expertise provided by a stakeholder group. Stakeholders including two Care Home Managers, two senior staff and two experts in the field with combined experience of more than 70 years were consulted on the development of a mealtime training guide.…”

Structure and agency attributes of residents’ use of dining space during mealtimes in care homes for older people

“…Previous studies identified numerous factors that influence residents’ experiences at mealtimes, including the material conditions of the dining room space (Chaudhury, 2013; McDaniel, Hunt, Hackes, & Pope, 2001; Passini, Pigot, Rainville, & Tétreault, 2000) and how well‐acquainted residents are with this space (Carrier, West, & Ouellet, 2009). Other factors include the presence, attitudes and training of the staff in how they interact and support residents (Bourdel‐Marchasson, 2010; Gibbs‐Ward & Keller, 2005; Simmons & Levy‐Storms, 2006), the quality of interactions between residents (Philpin, Merrell, Warring, Gregory, & Hobby, 2011), and the freedom of choice around food, place, time and companions (Carrier et al., 2009; Crogan, Evans, Severtsen, & Shultz, 2004; Watkins et al., 2017).…”