Interventions for Improving Mealtime Experiences in Long-Term Care

Abstract

Poor food intake in residents living in long-term care (LTC) homes is a common problem. The mealtime experience is known to be important in the multifactorial causes of food intake. Diverse interventions have been developed, implemented, and/or evaluated to improve the mealtime experience in LTC; it is possible that multicomponent interventions will have a greater benefit than single activities. To identify the range of feasible and potentially useful interventions for including in a multicomponent intervention, this scoping review identified and summarized 58 studies that described and/or evaluated mealtime experience interventions. There were several randomized controlled trials, although most studies used less rigorous methods. Interventions that are multicomponent (e.g., food service, dining environment, staff education) and target multilevel factors (e.g., residents, staff) in LTC appear to be feasible, with a variety of outcomes measured. Further research is still needed with more rigorously designed studies, confirming effectiveness, feasible implementation, and scaling up of efficacious interventions.

Improving Food and Fluid Intake for Older Adults Living in Long-Term Care: A Research Agenda

“…Several studies have demonstrated that an increase in staff time spent providing assistance to eat in LTC promotes food intake. 13,33,34 However, knowledge mobilization and sustainability of these successful interventions in daily care practice are key areas for future research, as well as demonstration that improved staff care practices are sustained and relate to other person-centered outcomes, such as autonomy, quality of life, and satisfaction. 38 The 5 senses of the dining environment (no.…”

“…Limited previous research has identified the importance of psychosocial interactions in LTC, 14,29,30 but research has yet to demonstrate that social interactions alone are an independent predictor of food intake in LTC. 13 However, apathy, which is characterized by limited engagement, is associated with weight loss. 31 It is important to note that family-style dining 32 or optimal assistance to eat 33 may also increase social interactions indirectly and have been shown to improve food intake, 32,33 body weight, 32,34 quality of life, and selffeeding ability.…”

“…To date, several interventions to improve dietary intake in LTC have been tested, many of which were multimodal. 13 Lack of effect with some of these interventions may be due to targeting less influential determinants of consumption or those factors not amenable to nutritional interventions. It is anticipated that the M3 conceptual framework can be used to identify targets for and guide the development of effective multimodal interventions to promote food and fluid intake for older adults living in LTC.…”

The effect of nutrition training for health care staff on learner and patient outcomes in adults: a systematic review and meta-analysis

“…Studies including pregnant women were excluded. All health care staff were included to reflect the wide range of vocations that receive nutritional training (11). Studies used a wide range of outcomes to investigate the efficacy of nutrition training, and as a result, studies were deemed eligible if they reported $1 patient-or learner-based outcome.…”

“…A number of systematic reviews and meta-analyses have investigated the impact of a variety of interventions designed to support staff in improving the nutritional care of patients or residents, including staff training in nutrition (6)(7)(8)(11)(12)(13)(14). None of these reviews, however, took into consideration the training strategies used even though training strategies may have a significant impact on learner and patient outcomes (15,16).…”