9
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      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

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          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.

          Related collections

          Most cited references26

          • Record: found
          • Abstract: found
          • Article: not found

          Comparison of energy and protein intakes of older people consuming a texture modified diet with a normal hospital diet.

          There are very few studies looking at the energy and protein requirements of patients requiring texture modified diets. Dysphagia is the main indication for people to be recommended texture-modified diets. Older people post-stroke are the key group in the hospital setting who consume this type of diet. The diets can be of several consistencies ranging from pureed to soft textures. To compare the 24-hour dietary intake of older people consuming a texture modified diet in a clinical setting to older people consuming a normal hospital diet. Weighed food intakes and food record charts were used to quantify the patients' intakes, which were compared to their individual requirements. The oral intake of 55 patients was measured. Twenty-five of the patients surveyed were eating a normal diet and acted as controls for 30 patients who were prescribed a texture-modified diet. The results showed that the texture-modified group had significantly lower intakes of energy (3877 versus 6115 kJ, P < 0.0001) and protein (40 versus 60 g, P < 0.003) compared to consumption of the normal diet. The energy and protein deficit from estimated requirements was significantly greater in the texture-modified group (2549 versus 357 kJ, P < 0.0001; 6 versus 22 g, P = 0.013; respectively). These statistically significant results indicate that older people on texture-modified diets have a lower intake of energy and protein than those consuming a normal hospital diet and it is likely that other nutrients will be inadequate. All patients on texture-modified diets should be assessed by the dietitian for nutritional support. Evidence based strategies for improving overall nutrient intake should be identified.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Effectiveness of mealtime interventions on nutritional outcomes for the elderly living in residential care: a systematic review and meta-analysis.

            The need to improve the nutrition of the elderly living in long term care has long been recognised, but how this can best be achieved, and whether (and which) intervention is successful in reducing morbidity is less well understood. The aim of this systematic review was to determine the effectiveness of mealtime interventions for the elderly living in residential care. Mealtime interventions were considered as those that aimed to change/improve the mealtime routine, practice, experience or environment. Following comprehensive searches, review and appraisal, 37 articles were included. Inadequate reporting in over half of the articles limited data quality appraisal. Mealtime interventions were categorised into five types: changes to food service, food improvement, dining environment alteration, staff training and feeding assistance. Meta-analysis found inconsistent evidence of effects on body weight of changes to food service (0.5 kg; 95% CI: -1.1 to 2.2; p=0.51), food improvement interventions (0.4 kg; 95% CI: -0.8 to 1.7; p=0.50) or alterations to dining environment (1.5 kg; 95% CI: -0.7 to 2.8; p=0.23). Findings from observational studies within these intervention types were mixed, but generally positive. Observational studies also found positive effects on food/caloric intake across all intervention types, though meta-analyses of randomised studies showed little evidence of any effects on food/caloric intake in food improvement studies (-5 kcal; 95% CI: -36 to 26; p=0.74). There was some evidence of an effect on daily energy intakes within dining environment studies (181 kcal/day, 95% CI: -5 to 367, p=0.06). The need to improve the nutrition of the elderly living in residential long term care is well recognised. This review found some evidence that simple intervention around various aspects of mealtime practices and the mealtime environment can result in favourable nutritional outcomes. Further large scale pragmatic trials, however, are still required to establish full efficacy of such interventions. Copyright © 2013 Elsevier B.V. All rights reserved.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial.

              To assess the effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents without dementia. Cluster randomised trial. Five Dutch nursing homes. 178 residents (mean age 77 years). Two wards in each home were randomised to intervention (95 participants) or control groups (83). During six months the intervention group took their meals family style and the control group received the usual individual pre-plated service. Quality of life (perceived safety; autonomy; and sensory, physical, and psychosocial functioning), gross and fine motor function, and body weight. The difference in change between the groups was significant for overall quality of life (6.1 units, 95% confidence interval 2.1 to 10.3), fine motor function (1.8 units, 0.6 to 3.0), and body weight (1.5 kg, 0.6 to 2.4). Family style mealtimes maintain quality of life, physical performance, and body weight of nursing home residents without dementia. Clinical trials NCT00114582.
                Bookmark

                Author and article information

                Journal
                Healthcare (Basel)
                Healthcare (Basel)
                healthcare
                Healthcare
                MDPI
                2227-9032
                03 December 2018
                December 2018
                : 6
                : 4
                : 140
                Affiliations
                [1 ]Rehabilitation, Aged and Extended Care, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia; clare.bradley@ 123456sahmri.com (C.B.); maria.crotty@ 123456flinders.edu.au (M.C.)
                [2 ]NHMRC Partnership Centre on Dealing with Cognitive and Related Functional Decline in Older People, Department of Rehabilitation and Aged Care, University of Sydney, Old Leighton Lodge, Hornsby Ku-ring-gai Hospital, Palmerston Road, Hornsby 2077, New South Wales, Australia
                [3 ]Institute for Choice, School of Commerce, University of South Australia, GPO Box 2471, Adelaide 5001, South Australia, Australia
                [4 ]Nutrition and Dietetics, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia; michelle.miller@ 123456flinders.edu.au (M.M.); Olivia.farrer@ 123456flinders.edu.au (O.F.)
                Author notes
                [* ]Correspondence: Rachel.milte@ 123456unisa.edu.au ; Tel.: +61-8-8302-0601
                Author information
                https://orcid.org/0000-0001-7533-6260
                Article
                healthcare-06-00140
                10.3390/healthcare6040140
                6316499
                30513902
                7e4201f6-d919-48ff-bdb1-5424ad83314c
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 31 October 2018
                : 29 November 2018
                Categories
                Article

                aged care,nursing homes,dementia,food,food services
                aged care, nursing homes, dementia, food, food services

                Comments

                Comment on this article