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.
Highlights
Poor nutritional status in people with dementia has been well described and is thought to result from reduced food and fluid intake below nutritional requirements, rather from an independent metabolic effect of the disease per se [1,2]
Providing meals in a family-style arrangement rather than a plated service has been associated with improved nutritional intake, increased social interaction during meals, and increased independence [10,11]
Comparison number choices texture modified diets in dementia-specific and nonspecific facilities. This cross-sectional study identified that overall, food-service and mealtime practices were similar. This cross-sectional study identified that overall, food-service and mealtime practices were between aged care homes with a dementia-specific unit and those without
Summary
Poor nutritional status in people with dementia has been well described and is thought to result from reduced food and fluid intake below nutritional requirements, rather from an independent metabolic effect of the disease per se [1,2]. To effectively address suboptimal food and fluid intake in people with dementia, residential aged care facilities need to consider the nutritional quality of the food, and to address functional, cognitive, behavioral, psychological, and social barriers to adequate food and fluid intake [3]. The use of high visual contrast tableware (i.e., bright red crockery) can promote oral intake and functional independence by overcoming visual deficits [7]. Providing sensory cues such as the sight of tables set for dinner, sounds of meal preparation, or the smell of appealing foods cooking can orientate people with dementia to the fact it is mealtime [6]. Promoting choice at the time of the meal has been associated with increased quality of life in residents [12]
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