How Widely are Supportive and Flexible Food Service Systems and Mealtime Interventions Used for People in Residential Care Facilities? A Comparison of Dementia-Specific and Nonspecific Facilities

Abstract

While improved mealtime practices can reduce agitation, improve quality of life, and increase food intake for people in aged care, the degree of implementation of these strategies is unknown. This study describes food service practices in residential aged care facilities, focusing on units caring for people with dementia. An online survey was distributed to residential aged care facilities for completion by the food service manager (n = 2057). Of the 204 responses to the survey, 63 (31%) contained a dementia-specific unit. Most facilities used adaptive equipment (90.2%) and commercial oral nutritional supplements (87.3%). A higher proportion of facilities with a dementia-specific service used high-contrast plates (39.7%) than those without (18.4%). The majority of facilities had residents make their choice for the meal more than 24 h prior to the meal (30.9%). Use of high contrast plates (n = 51, 25%) and molds to reform texture-modified meals (n = 41, 20.1%) were used by one-quarter or less of surveyed facilities. There is a relatively low use of environmental and social strategies to promote food intake and wellbeing in residents, with a focus instead on clinical interventions. Research should focus on strategies to support implementation of interventions to improve the mealtime experience for residents.

A systematic review of specialty dementia care units in long‐term care settings

“…Of 13 selected international comparison studies, five found little‐to‐no difference between residents living with ADRD in DSCUs and TNHs in terms of nutritional status, case conferences, mealtime experiences, and resident care and attention (Table 6). 93–97 Although not statistically significant, residents with dementia in DSCUs and TNHs were found to be different in terms of age, strength, and mobility in one study (e.g., residents in DSCUs were stronger and younger than residents in TNHs), 94 and in terms of content of case conferences (e.g., fewer case conferences regarding challenging behaviors were conducted in DSCUs compared to TNHs) in another study 95 . However, three studies reported worse outcomes among residents in DSCUs compared to residents in TNHs (e.g., higher rates of antipsychotic medications, social isolation, and burdensome transitions at the end‐of‐life) 98–100 .…”

Factors associated with perceptions of dignity and well‐being among older people living in residential care facilities in Sweden. A national cross‐sectional study

“…Previous research shows that food intake at RCFs is affected by the dining environment and social interactions at mealtimes (Keller et al., 2015). However, the use of environmental and social strategies to promote food intake is fairly low (Milte et al., 2018). From this study, we know that there are associations between dignity and well‐being and the mealtime environment, but we do not know what factors in the mealtime environment affect dignity and well‐being.…”

Regional Regulations and Public Safety Perceptions of Quality-of-Life Issues: Empirical Study on Food Safety in China

“…Yeung et al [ 8 ] attributed public perceptions of food safety to three sources, i.e., bacteria, chemical additives and new technologies such as transgenic technology. Moreover, media reports [ 27 ] a risk prewarning system [ 28 ] and information communication [ 29 ] significantly affect public perceptions of food safety. A study conducted by Hohl et al [ 30 ] with data from 25 European countries identified the three most important exogenous factors and revealed that cross-national diversity may contribute to different perceptions of food safety.…”