Using Family-Style Meals to Increase Participation and Communication in Persons with Dementia

Abstract

Although researchers stress the importance of encouraging independent behavior in persons with dementia, institutional practices often foster dependence. This study took place in a six-resident locked dementia care unit that followed the common institutional practice of serving meals on prepared plates. The purpose of this study was to examine if changing the mode of meal delivery to "family-style," where residents were presented with serving bowls and empty plates, would increase resident communication and participation in mealtime tasks. An ABAB' reversal design revealed very low rates of appropriate communication (5% of intervals) and mealtime participation (10% of tasks) during baseline, when residents received prepared plates (A). Communication and participation doubled when family-style meal delivery was introduced (B) and dropped back to baseline levels when it was withdrawn (A). Because the levels of communication and participation during family-style meals were still low, the nursing assistant was provided with instruction on prompting and praising appropriate mealtime behaviors (B'). After instruction was provided and family-style meals were reintroduced, resident participation rose to 65% of tasks and appropriate communication increased to 18% of observations. This study suggests family-style meals may result in modest increases in mealtime participation and communication of residents with dementia, but staff training in prompting and praising may be necessary to see large changes in these behaviors.

Sharing Meals With Institutionalized People With Dementia: A Natural Experiment

“…Several authors dealing with populations from different countries-Sweden, Norway, England, United States-have implemented mealtime routine alterations with people with dementia and have found positive outcomes such as enhanced communication, weight increase, autonomy, and quality of life (Althus, Engleman, & Mathews, 2002;Davis, Byers, Nay, & Koch, 2009;Mamhidir, Karlsson, Norberg, & Mona, 2007;Zgola & Bordillon, 2003). Depending on the culture of origin, authors suggested that opportunities to drink a glass of wine before the meal, to adopt family-style meals, or even to enjoy finger food can be advantageous.…”

Factors influencing quality of life of elderly people with dementia and care implications: A systematic review

“…In conclusion, only eight quantitative studies (Li et al, 2012;Edvardsson, 2014;Marventano et al, 2015;Wetzels et al, 2010;Crespo et al, 2011;Black et al, 2012;Terada et al, 2012;Monteiro et al, 2014 ) are considered to be as high quality, which meet all the quality criteria. Five articles were considered to be low-quality articles (Altus et al, 2002;Winzelberg et al, 2005;Hodgson et al, 2014;Heggie et al, 2011;Banerjee et al, 2005), as they only meet one or two criteria (See Table 1). The quality of the remaining 26 studies are judged as moderate.…”

Mealtimes in Nursing Homes: Striving for Person-Centered Care

“…Yet simply making changes to the design of the dining room and how food is served does not ensure that the dining experience will be pleasant, or that the social side of eating will be enhanced. Much depends on the way staff interacts with residents and how they facilitate conversation at the table (17,18). Pleasant dining experiences are created when staff value the social aspect of meals and find ways to honor residents as individuals.…”