Public home care professionals’ experiences of being involved in food distribution to home-living elderly people in Sweden – a qualitative study with an action research approach

Abstract

Background: Research focusing on Food Distribution (FD) from various professionals' and organisational perspectives are lacking. The aim of this study was therefore to explore various professionals' experiences of involvement in FD in order to get comprehensive understanding of the organisation, responsibilities and roles. Methods:This qualitative study is a part of a larger project with an action research approach focusing on FD in the municipal home service and care for home-living elderly persons in a municipality in southern Sweden. The data was collected through participatory observations (n=90 occasions and in total 480 hours), repeated focus group interviews (n = 4) with different professionals (n =10) involved in the FD process and one individual interview. The material was analysed by qualitative manifest and latent content analysis. Results:The study indicates that Food Distribution is a fragmentary intervention where a comprehensive perspective and clear roles of responsibility are lacking. The FD organisation seemed to be strictly divided and limited by constraints regarding time and money. The fragmented organisation led partly to staff only taking responsibility for their part of the chain and no one having the full picture of and responsibility for the FD process, but also to some professionals taking more responsibility than they were supposed to. Conclusions:The aim of the study was met by using an action research approach. The study was however limited by that no home help officers were represented. The FD appeared as an extremely complex chain of different but connected activities. It is not merely the distribution of a product, i.e. the meal box. The fragmentation of FD means that staff only takes responsibility for their part of the chain, and that no one has the full picture of or responsibility for the FD process. Consequently, there is a need for an outline of responsibilities. The findings have implications for nursing, gerontology, and in the care for the elderly.

Food Preparation at Home an Example of New Practical Strategies in the Swedish Municipal Food Service - A Qualitative Study

“…This is confirmed by results from other studies were it is shown that relatives of the municipal FS service users advocate a food preparation service in the home of the recipient reasoning that food preparation at home creates a real sense of homemade food and of being at home. Further, the studies highlighted the importance of the social aspects of the new FS that relieves loneliness and isolation among the recipients living alone and without frequent contact with other people (Pajalic, 2013c;Pajalic et al, 2012b). Another study showed that an individual's experiences are important because these experiences in combination with those of the FS personnel are important when promoting a holistic view on nutrition and better quality of life for individuals requiring help with meal preparation needs related to food intake (Odencrants, 2008).…”

“…For this study manifest content analysis was used for analysis of the transcribed interview texts and notes from the participant observations (Krippendorff, 2004;Pajalic, Persson, Westergren, Berggren, & Skovdahl, 2012;Pajalic, Persson, Westergren, & Skovdahl, 2012b;Spradley, 1980). Qualitative content analysis is an interpretation process that focuses on similarities and differences in various parts of the transcribed text (Krippendorff, 2004).…”

Facilitating Change, the Decision-maker’s Views of Municipality Organized Food Distribution to Elderly People Living at Home and Suggestions for Development – A Participatory Action Research Study

“…the various professionals' roles and responsibilities from being involved in FD (Pajalic, et al, 2012a) 2. the elderly persons experiences of receiving food distributed by the FD service (Pajalic, et al, 2012b) 3. participation based intervention for improving FD practice (Pajalic, et al, 2012c) 4. DM's views on the FD service and suggestions for which areas should be taken into consideration as starting points for changing the FD process and practice which was the subject of the first part of the present study.…”

“…Food was produced at a municipality owned kitchen. The diet manager had the overall responsibility for the food production and the personnel employed at the kitchens (Pajalic, Persson, Westergren, Berggren, & Skovdahl, 2012b;Pajalic, Persson, Westergren, & Skovdahl, 2012a). The municipal kitchen is subordinate to the municipal care and service administration which is led by the administrative manager who in turn is subordinate to the management committee represented by politicians (elected citizens' representatives, n=23).…”

“…The study is based on the different perspectives of the FD recipients (Pajalic, et al, 2012b), the various involved professionals in the FD chain (Pajalic, et al, 2012a) and participation based intervention for identifying development areas and improving FD practice (Pajalic, Persson, Westergren, & Skovdahl, 2012c). This study shows that the FD service should not been seen as fragmentary social support.…”