Mealtime Environment - "Living to Eat"

Nutrition and eating are important factors for the person with dementia, affecting their quality of life, health and admittance to long-term care facilities. People with dementia living in the community are often at risk for poor food intake and weight loss, and frequently are admitted to long0term care facilities in undernourished states. They are also more likely to have eating behaviours that affect their food intake (e.g. self-feeding difficulties, eating non-foods, and confusion with utensils). This in turn often creates stress and burden for caregivers. Additionally, there is the potential that these eating changes can influence family relationships and their traditions.

This study follows up on the theory created in the initial Eating Together study, where it was identified that the mealtime experience was important to the family relationship.

This project is being done in collaboration with the Murray Alzheimer Research and Education Program (MAREP) at the RIA.

Heather Keller
Zoe Martos

Mealtime satisfaction is important to identify and to continually evaluate in order to ensure that quality care and quality of life are promoted for older adults living in long term care facilities. A few mealtime satisfaction questionnaires have been developed, but they are either limited by content/scope or format. A draft questionnaire has been developed by the researchers and is believed to be superior. To ensure that this is the case, pretesting with older adults in long term care facilities is essential. Subsequent studies will undertake validation and reliability testing.

Research suggests that the social environment is important to quality of life and food intake for older adults living in long term care facilities. To date, little attention has been paid to measuring the social interaction that occurs at the table. The researchers have developed a draft observational tool that can be used in such settings. This protocol will allow for refinement of the observational method as well as reliability testing.

The development of such a measure will assist with tracking social interaction, especially before and after interventions designed to promote a positive social experience.

As an extension to the initial exploratory study looking at social interaction among tablemates during mealtime, this research team will conduct interviews to find out what the mealtime experience is like for older adults in the setting. The primary focus will be to understand the psychosocial aspect of mealtime from conversations with residents.

Understanding what affects the mealtime experience is relevant as it is one of the few consistent times each day for older adults to come together and interact. Interviews are the next step in this study to understand relationships and interactions between tablemates, mealtime roles, and residents’ relationship with food. Educational initiatives for health care workers, administrative staff, and residents are ideal outcomes of this research.

The research team was interested in identifying positive and negative aspects of social interaction at mealtime for residents living in retirement homes. Prior to this study, there was no research on the psychosocial aspects of meals being conducted in this type of facility. Participant observation was used to identify what types of social interaction occurred and those things that influenced it among tablemates.

Conducted in partnership with several local Alzheimer Chapters in South Central Ontario, this longitudinal project is designed to: (1) examine the experience and meaning of food and mealtimes for persons living with dementia and their partners in care; and (2) understand how the experiences and meanings of food and mealtimes change over time for persons living with dementia and their partners in care.

The ultimate goal of this project is to gain a better understanding of the issues faced by families experiencing dementia specifically related to food and mealtimes in order to inform the development of educational tools and interviews to better assist families with these issues. (Funded by the Social Sciences and Humanities Research Council and the Alzheimer Society of Canada).

A number of Fact Sheets on eating and meal times in the dementia context have been created as part of this project. Online versions can be obtained by clicking here or by visiting the MAREP website.

*This project is a collaborative effort between the MAREP and A-HA research themes at the RIA.