Improving meal context in nursing homes. Impact of four strategies on food intake and meal pleasure

Abstract

In France, in most nursing homes, the composition of menus, the time and the place at which meals are served, the choice of one's place at the table are imposed on residents. Yet, the act of eating cannot be restricted to nutritional and sensory aspects alone. It also includes a psycho-affective dimension, which relates to the context in which the meal is served. We tested the impact of four contextual factors, considered individually, on food intake and meal pleasure in elderly people living in nursing homes: the way the main course was named on the menu, the size and the variety of portions of vegetables served to residents, the presence or not of condiments in the middle of the table and the presence or not of elements to modify the surroundings such as a decorative object on the table or background music. Twelve experimental meals were served to 42 nursing home residents. For each factor, we compared a control condition with two experimental conditions. Our study showed that changing a single contextual element of the meal in nursing homes could be sufficient to improve residents' satisfaction with their meals and increase the quantities of meat or vegetables consumed, as long as this factor had a direct impact on what was going to be consumed (increased variety on the plate, condiments on the table). Factors affecting the context of the meal (names of dishes, decor) proved to be ineffective. Given the budgetary constraints faced by nursing homes, this study proposes interesting and inexpensive ideas to increase satisfaction with meals and food intake in elderly people who are dependent on others for their meals.

Older people's involvement in activities related to meals in nursing homes

“…Lack of perceived choices in menus can be a potential barrier to achieving optimum nutrition. More choices concerning meals may enhance the autonomy of residents, and in turn improve residents' appetite and positively influence their nutritional status (Chisholm et al, 2011;Wikstr€ om & Emilsson, 2014;Divert et al, 2015).…”

Moments of joy and delight: the meaning of traditional food in dementia care

“… and Divert et al . ). In France, 15–38% of nursing home residents suffer from malnutrition (Divert et al .…”

“…In France, 15–38% of nursing home residents suffer from malnutrition (Divert et al . ), while one‐third of nursing homes residents in Finland (Suominen et al . ) do the same, and Crogan and Pasvogel () claim that as many as 85% of older nursing home residents in the United States are undernourished.…”

Influence of flavour enhancement on food liking and consumption in older adults with poor, moderate or high cognitive status

“…Moreover, the lack of appetite observed in older adults (Morley & Silver, 1988) does not solely result from sensory deficits but is also linked to a physiological dysregulation of food intake control (Rolls, 1999). More broadly, numerous factors can influence food intake in older adults; they may be linked to the food product and its sensory properties or the subjects and their physical, physiological and psychological state, but also linked to the meal context (Divert et al, 2015). In cognitively impaired older adults, the relative importance of these factors remains unknown and requires further investigation.…”