How are the mealtime experiences of people in residential aged care facilities informed by policy and best practice guidelines? A scoping review

Abstract

Background Mealtimes are embedded routines of residents living in residential aged care facilities (RACFs) that directly impact their health and quality of life. Little is known about how mealtime experiences are informed and affected by structures such as government and organisational policies and processes. This scoping review used Giddens’ (The constitution of society: outline of the theory of structuration, 1984) Structuration Theory to investigate how governance structures related to mealtime practices inform residents’ mealtime experiences. Methods Using Arksey and O’Malley’s (Int J Soc Res Methodol 8:19–32, 2005) scoping review framework, a systematic database, grey literature and policy search was completed in May 2020 and updated in July 2021. From 2725 identified articles, 137 articles were included in data charting and deductive analysis, and 76 additional Australian government policy papers were used interpretatively. Results Data charting identified that the included studies were prominently situated in Western countries, with a progressive increase in publication rate over the past two decades. Qualitative findings captured structures that guide RACF mealtimes, how these relate to person-centred mealtime practices, and how these facilitate residents to enact choice and control. Conclusions Current policies lack specificity to inform the specific structures and practices of RACF mealtimes. Staff, residents, organisational and governance representatives possess different signification, legitimation and domination structures, and lack a shared understanding of policy, and how this influences processes and practices that comprise mealtimes.

Person‐centred and task‐centred care: Impact on mealtime behaviours in nursing home residents with dementia

“…This study supported the impact of staff person-centred care on A shared vision and accountability of implementing person-centred care to improve resident mealtime experiences and sustain quality care is critical and requires collaboration among stakeholders (Fazio et al, 2018;Koh et al, 2021).…”

“…Direct care staff turnover and lack of adequate training, especially during pandemics, disrupts the continuity of quality care practice and expedites resident risks of rapid functional decline and malnutrition. A shared vision and accountability of implementing person‐centred care to improve resident mealtime experiences and sustain quality care is critical and requires collaboration among stakeholders (Fazio et al, 2018 ; Koh et al, 2021 ).…”

“…The Social Ecological Model provides a multilevel framework to conceptualise social determinants of health from intrapersonal, interpersonal, environment and policy levels (McLaren & Hawe, 2005 ). Following this model, multilevel factors at resident, staff, environmental and institutional levels that influence resident mealtime behaviours and intake were examined (Douglas et al, 2020 , 2021 ; Koh et al, 2021 ; Liu et al, 2016 ; Liu, Jao, et al, 2019 ; Liu, Tripp‐Reimer, et al, 2020 ). Resident‐level factors include age, sex, cognition, physical capacity, eating function, dental‐related function, appetite and ability to see, hear and communicate (Cipriani et al, 2016 ; Liu et al, 2016 ; Liu et al, 2019 ; Liu et al, 2022; Morrison‐Koechl et al, 2021 ).…”

“…At the environmental and institutional level, physical and social dining environment has demonstrated inconsistent evidence on resident behaviours and intake (Bunn et al, 2016 ; Liu et al, 2014 ; Liu et al, 2015 ; Poscia et al, 2017 ). However, the role of a supportive physical dining environment and institutional infrastructure in fostering positive mealtime experiences and intake has been acknowledged (Chaudhury et al, 2013 ; Koh et al, 2021 ). Recent work also supports the role of quality social dining environment and food stimuli on resident behaviours and intake (Liu et al, 2017 ; Liu, Jao, et al, 2019 ).…”

“…Following this model, multilevel factors at resident, staff, environmental and institutional levels that influence resident mealtime behaviours and intake were examined (Douglas et al, 2020(Douglas et al, , 2021Koh et al, 2021;Liu et al, 2016;Liu, Jao, et al, 2019;Liu, Tripp-Reimer, et al, 2020). Resident-level factors include age, sex, cognition, physical capacity, eating function, dental-related function, appetite and ability to see, hear and communicate (Cipriani et al, 2016;Liu et al, 2016;Morrison-Koechl et al, 2021).…”