Consumer Satisfaction of Texture Modified Meals Served in Residential Aged-Care Facilities

Abstract

Food service plays an important role in optimising residential aged care facilities (RACFs) residents' health with mealtime satisfaction a critical component. One third of residents consume texture-modified diets (TMDs). This study investigated satisfaction of TMDs in RACFs collecting documentation audit and interviews with residents and their carers at 12 RACFs. Eating Assessment Tool (EAT-10) and Mini Nutritional Assessment (MNA-SF®) were completed. Inclusion criteria was residents receiving commercially prepared nutrient-fortified TMD meals. 67 residents (aged 68-99yrs) were audited and 39 were interviewed. 97% of residents had documented cognitive impairment. 84% had elevated EAT-10 and 97% were at risk of malnutrition on MNA-SF®. The majority (>80%) of residents were satisfied with the flavour of their meals. Residents in RACFs receiving TMDs have complex medical issues, dysphagia and malnutrition risk. Yet, two thirds of residents were able to offer suggestions for mealtime improvements. Food services should not discount their contributions in menu planning.

Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review

“…On hospital admission, dementia patients with dysphagia had a higher prevalence of malnutrition and a significantly higher risk of malnutrition compared to those without dysphagia [ 43 ]. Mean MNA-SF scores measured by Miles et al and Vucea et al also indicated the TMD consumers in LTCs were at risk of malnutrition [ 44 , 45 ]. Similar MNA-SF results were found in hospital patients consuming TMDs [ 39 , 46 ].…”

“…The use of an interview was the most common method for exploring mealtime satisfaction [ 44 , 54 , 55 , 58 ]. Three studies evaluated mealtime satisfaction for shaped/moulded TMDs by survey [ 5 , 47 , 48 ].…”

“…A finding mimicked in the current review. Malnutrition was reported in 33–50% of dysphagic residents in LTCs and approximately 60% in hospital [ 37 , 44 , 46 , 59 ].…”

“…Weight loss was more significant in oral cancer patients on TMDs compared to those on standard diets in a retrospective study [ 50 ]. Missing documentation or measurement of weight and height was observed in LTCs, suggesting inadequate monitoring [ 44 ]. The risk of malnutrition is highly associated with weight and BMI, and as such regular assessment and documentation are necessary.…”

Cost, microbiological, and nutritional properties of pureed food production in nursing homes. The ABADIA Study

“…Another reason for prescribing TMD is to reduce the risk of choking and prevent aspiration pneumonia. Up to 70 % of institutionalized people may suffer from choking during meals (33). Evidence of symptoms related to swallowing (such as choking) associated with hTMD vs. cTMD is minimal; moreover, results on the effectiveness of TMD to prevent aspiration pneumonia are inconclusive (34,35).…”