Sharing Meals With Institutionalized People With Dementia: A Natural Experiment

Abstract

Nutritional deficiency can have dramatic effects on the physical and psychological status of older adults. Although food supplements can enhance nutritional status, several authors suggest that more ecological means could also have beneficial impacts. Therefore, a natural experiment was conducted to study the impact of changed mealtime experiences for people with Alzheimer-type dementia. Two special care units (in separate facilities) in France were included in this study: one implemented shared meal times between residents and caregivers and the other served as a comparison group. Weight was measured and staff observations were collected. Positive outcomes were observed for the experimental group. Implications for practice are discussed.

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

“…However, a limited number of studies have quantified the impact of contextual improvement on food intake and/or on the nutritional status of institutionalized people (Abbott et al, 2013). Some of them focused on the effectiveness of a single change such as providing smaller portions (Cluskey & Dunton, 1999), switching from a prepared tray to a bulk service (Shatenstein & Ferland, 2000), having the staff share the meals with the residents (Charras & Frémontier, 2010), enhancing the colour contrast of the crockery that food was served on (Dunne, Neargarder, Cipolloni, & Cronin-Golomb, 2004), improving lighting (Brush, 2002) or diffusing music in the dining room (Ragneskog, Brane, Karlsson, & Kihlgren, 1996;Thomas & Smith, 2009). Six studies assessed large-scale changes which mainly aimed at shifting the dining room from an institutional appearance to more home-like setting ( Table 1).…”

ESPEN guidelines on nutrition in dementia

“…In a controlled trial, implementation of a breakfast club resulted in increased communication and independence, interest and involvement [97]. Another controlled study in two special care units for persons with dementia in France reported positive effects on body weight and eating behavior as a consequence of shared mealtimes between residents and caregivers [98].…”

Interventions for Improving Mealtime Experiences in Long-Term Care

“…Five of these intervention studies were quasi-experimental with a comparison group (45,56,57,61,83) while another five were a single group with a pretest-posttest design (40,53,(84)(85)(86). The final study had a posttest design and involved qualitative observations at seven sites that received the intervention (62).…”

“…The comparison group quasi-experimental studies originated from France (56), United States (83), and Sweden (45,57,61). Charras investigated a training program implemented in one LTC facility (n ¼ 8) versus another facility with no training program put in place (n ¼ 10) (56). The 12 sessions focused on dementia training and shared mealtimes between staff and residents and emphasized the importance of resident-centered mealtimes (56).…”

“…Charras investigated a training program implemented in one LTC facility (n ¼ 8) versus another facility with no training program put in place (n ¼ 10) (56). The 12 sessions focused on dementia training and shared mealtimes between staff and residents and emphasized the importance of resident-centered mealtimes (56). There was significant (P < 0.02) weight gain for the residents in the facility where the staff received the training program as compared to residents in the facility with no training (56).…”