Is the mealtime experience in nursing homes understood? A qualitative study

Palacios‐Ceña, Domingo; Iglesias, Marta Elena Losa; Cachón‐Pérez, José Miguel; Gómez-Pérez, Daniel; Gómez‐Calero, Cristina; Fernández‐de‐las‐Peñas, César

doi:10.1111/j.1447-0594.2012.00925.x

Cited by 40 publications

(61 citation statements)

References 37 publications

(139 reference statements)

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“…Such findings are at clear odds with the resident preferences as expressed in the current study. Mealtimes in particular are an opportunity for residents to exercise some control over part of their life in care, for example through deciding what to eat, where to eat, when to eat and with whom [42]. This is acknowledged by the British Geriatrics Society (2011), which highlights the importance of involving residents in decisions about their care, including aspects of care relating to mealtimes [4].…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, there was a perennial juxtaposition between individual and group interests, as exemplified by meal options or by seating allocation. In the wider literature, mealtimes have been described as offering a sense of social normality with residents sharing food, passing condiments and pouring drinks for each other, thereby contributing to a feeling of belonging [16, 42] and possibly enhancing a sense of community. At the same time, some residents clearly prefer privacy (i.e., eating alone) at mealtimes with ‘homeliness’ associated more closely with family than with fellow residents of staff [45].…”

Section: Discussionmentioning

confidence: 99%

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Exploring residents’ experiences of mealtimes in care homes: A qualitative interview study

et al. 2017

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BackgroundMany interventions aim to alleviate well-documented problems of malnutrition in residential care homes and improve residents’ health and wellbeing. Despite some positive findings, little is known about how and why mealtime interventions might be effective, and in particular, what effects residents’ experiences of mealtimes have on health outcomes. The aim of this study was to gain an insight into these experiences and explore some of the issues that may impact on residents’ enjoyment of meals, and resulting health and wellbeing.MethodsSemi-structured interviews were conducted with eleven residents from four care homes in the South West UK. Thematic analysis was used to derive content and meaning from transcribed interviews. Interviews were supplemented by researcher observations of mealtimes.ResultsThe dining experience was a focal point for participants’ broader experiences of residing in a care home. Three themes pertaining to residents’ experiences were identified: (1) Emotional and psychological connections with other residents; (2) managing competing interests with limited resources; and (3) familiarity and routine.ConclusionMealtimes are a mainstay of life in a care home through which residents’ experiences are characterised, exemplified and magnified. Understanding how residents interact with one another, accommodating their preferences and encouraging autonomy may enhance their mealtime experiences. It may also help to ease the transition from independent-living to life in care, which can be particularly stressful for some residents, and improve health and wellbeing over the long-term.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Exploring residents’ experiences of mealtimes in care homes: A qualitative interview study

et al. 2017

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“…As the most basic activity of daily living (ADL) for older adults, eating performance is usually the easiest function to restore after decline or loss(2–4). Maintaining independent eating performance at mealtimes not only promotes social engagement and enjoyment of meals, but also enhances functional autonomy and ensures adequate food intake to maintain nutritional status as a fundamental health need(5, 6). …”

Section: Introductionmentioning

confidence: 99%

“…Beyond the intrapersonal factors, eating performance is also associated with multiple factors at the interpersonal, environmental, and policy levels(12). Interpersonal factors that relate to caregiver characteristics include caregivers’ perceptions and skills for engaging the resident in eating, dyadic communication and interaction, and mealtime assistance such as verbal cues and role modeling(5, 6, 25–27). Environmental factors include both physical environment (e.g., lighting, noise, tableware contrast, use of finger food, and availability of adaptive devices) (20, 23, 28), and social and cultural contexts (e.g., food delivery style, dining routines, social engagement, and cultural aspects of food choices)(29–31).…”

Section: Introductionmentioning

confidence: 99%

The association of eating performance and environmental stimulation among older adults with dementia in nursing homes: A secondary analysis

Liu

Jao

Williams

2017

International Journal of Nursing Studies

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Background Nursing home residents with dementia experience increased risk for compromised eating performance due to intrapersonal, interpersonal, and environmental factors. Environmental stimulation is physical, social, and/or sensory stimulation present in the environment that can potentially trigger individuals’ emotion or motivate physical reactions. Beyond the personal factors, there is a lack of evidence on how environmental stimulation influences individuals’ eating performance at mealtimes. Objectives This study examined the association between environmental stimulation and eating performance among nursing home residents with dementia. Design This study was a secondary analysis using baseline videos selected from a communication intervention study, where videos were recorded to capture staff-resident interactions during care activities for nursing home residents with dementia. Videos were included in this study only if residents demonstrated eating activities at mealtimes. Sample and Setting A total of 36 videos were selected (mean length = 4 minutes). The sample included 15 residents with dementia (mean age = 86), and 19 certified nursing assistants (mean age = 36) in 8 nursing homes. Methods The dependent variable was eating performance as measured by the Level of Eating Independence scale (range: 15–36, with higher scores indicating better eating performance). The independent variables were characteristics of environmental stimulation measured by the Person-Environment Apathy Rating-Environment subscale (stimulation clarity, stimulation strength, stimulation specificity, interaction involvement, physical accessibility, and environmental feedback). Each characteristic was rated on a 1–4 scale with higher scores indicating more desirable environmental stimulation. Multilevel models were used to examine the association between eating performance and environmental stimulation, adjusting for resident characteristics (i.e., age, gender, dementia stage, function, comorbidity, psychoactive medication use) and nesting effects of residents and staff. Results Resident participants demonstrated moderate levels of eating performance (M=27.08, SD = 5.16). Eating performance was significantly lower among older residents, those with more advanced dementia, and higher comorbidity. After controlling for resident characteristics, eating performance was significantly associated with stimulation specificity (how the stimulation is delivered and tailored to the resident), and was not associated with other environmental stimulation characteristics. For each 1 point increase in stimulation specificity, eating performance increased by 8.78 points (95% CI=.59, 16.97). Conclusions Environmental stimulation that is personally tailored to a resident’ needs and preferences and directly offered to a resident contributed to better eating performance among residents with dementia. The findings will direct future development and implementation of person-directed mealtime care programs and dining environment arrangements fo...

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“…Although financing, organization, and accreditation differences exist across residential aged care settings in an international context, the importance of mealtimes and the need for individualized management of mealtime difficulties is well recognized and has been emphasized in the literature (5)(6)(7)(8)(9)(10)(11)(12). To align service provision with local and international aging policy, mealtime management must be both multidisciplinary and consistent with a person-centered care approach (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Perspectives on Mealtime Management in Residential Aged Care: Insights From a Cross-Disciplinary Investigation

Bennett

Ward

Scarinci

et al. 2014

Journal of Nutrition in Gerontology and Geriatrics

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Meeting the medical, nutritional, and psychosocial mealtime needs of aged care residents requires a holistic, multidisciplinary approach. To date the perspectives of this multidisciplinary team have not been adequately explored. The aim of this study was to explore the perspectives of a range of service providers involved in mealtime management in residential aged care. In-depth semistructured interviews were conducted with 61 participants from five service disciplines. Four themes emerged: ( 1 ) mealtimes are highly valued; ( 2 ) service providers face common barriers to mealtime management; ( 3 ) communication among service providers is challenging; and ( 4 ) education in mealtime management is limited. Data indicated service providers acknowledge the importance of mealtimes but recognize numerous shortfalls in current care. The need for interdisciplinary training and increased communication and collaboration among providers was emphasized, including the need for clarification of provider roles. Limited consideration of mealtimes in policy and funding documents was identified as a primary barrier in further prioritizing mealtime management and advancing mealtime care.

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Is the mealtime experience in nursing homes understood? A qualitative study

Abstract: Understanding the social significance of meals for residents in nursing homes would provide deeper insight into resident expectations. This will in turn help to improve service and quality of life for residents.

Cited by 40 publications

References 37 publications

Exploring residents’ experiences of mealtimes in care homes: A qualitative interview study

Exploring residents’ experiences of mealtimes in care homes: A qualitative interview study

The association of eating performance and environmental stimulation among older adults with dementia in nursing homes: A secondary analysis

Perspectives on Mealtime Management in Residential Aged Care: Insights From a Cross-Disciplinary Investigation

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