Time for reflection improves elderly’s mealtime experience



A year of recurrent staff supervision, headed by a dietitian, at nursing homes for the elderly in Sweden resulted in a better mealtime situation for residents. Improvements were observed in how tables were laid and food was served, in sound levels and in social interaction between staff and users, as a new thesis from Uppsala University shows. The memory capacity of some of the elderly residents at the homes concerned also benefited.

In a food and meal project conducted at eight nursing homes for the elderly, a year’s supervision of the staff proved more effective than more traditional training initiatives in terms of improving both the mealtime environment and the staff’s ability to implement change. In the course of a one-year project, an experienced dietitian met a small, select group of staff once a month. On these occasions, the group had the opportunity to reflect on and discuss how they worked with reference to food, meals and nutrition. Repeated observation studies showed that the mealtime environment improved in several respects, such as adapted and attractive table presentation, the meal beverages offered and meals served, the social contacts between staff and residents, and less disturbing noise from the kitchen.

Questionnaire surveys showed that the staff also felt that they had better scope for achieving change in terms of more positive attitudes; a clearer division of responsibility for food and meals; and resources in the form of time, management support and tools.

‘We were able to see a delayed decline in memory capacity in the elderly residents at the nursing homes where the staff had received a year’s supervision. This may possibly be explained by a more stimulating mealtime environment and the enhanced interplay between the staff and residents,’ says the author of the thesis, Johanna Törmä.

The thesis also shows that malnutrition is still common in Swedish nursing homes. Nearly a third (30%) of the residents were judged to be malnourished and nearly two-thirds (63%) to be at risk of malnutrition. Malnutrition was strongly associated with impaired functional ability and memory capacity and elevated mortality. Nevertheless, a possible improvement since 1996 was observed: a lower proportion of malnourished residents was found in the survey in question, implemented in 2010 .

The results underline the importance of active efforts to improve food and meal management for the elderly.

Full article: Johanna Törmä (2017): Implementation strategies for nutritional guidelines in nursing homes: Effects on care staff and residents. Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences (IFV), Uppsala University.

Linda Koffmar

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