Structure and agency attributes of residents’ use of dining space during mealtimes in care homes for older people

Abstract

Georg Simmel's 1910 essay on 'The Sociology of the Meal' argues that eating together at mealtimes creates invaluable opportunities for socialising while strengthening a group's social norms (Simmel, Frisby, & Featherstone, 1997; Symons, 1994) while bridging the public and private spheres of life (Simmel et al., 1997). In old age, having companions at mealtimes is associated with increased food intake, whereas those dining alone are at greater risk of malnutrition (Hetherington, Anderson, Norton,

How are the mealtime experiences of people in residential aged care facilities informed by policy and best practice guidelines? A scoping review

“…These meanings were unique, formed from combined factors related to each resident’s experience. Factors included staff [ 83 , 97 , 152 ]; social interactions [ 22 , 30 , 99 ], personhood [ 23 , 120 ], food service [ 157 ] and environment [ 16 , 24 ] that each shape their mealtime experiences.…”

“…Traditionally, RACFs follow a bio-medical model [ 135 , 144 ], but changing public expectations, evidence and the marketization of residential care have directed more RACFs to provide home-like environments [ 27 ]. However, many RACFs continue to view residents as care-dependent consumers with structures that institutionalise residents’ understanding of mealtimes, including mealtime schedules, menus and seating arrangements that privilege routine, standardisation and dependence [ 5 , 24 , 117 ]. “When a resident moves in they find the menu already set and organised and then have to adjust to being told when to eat, what meals are served and who they will be sharing a meal with in the dining room.” ([ 5 ] p36) …”

“…Despite evidence demonstrating the benefit for residents of mealtime environments that encourage choice and independence, logistical barriers often prevent RACFs from adopting these approaches [ 24 ]. Person-centred care (PCC) approaches provide choice and control on when, what and where to eat, encouraging mealtime participation that improves resident QoL, and are considered best-practice [ 12 , 23 , 25 ].…”

“…Person-centred care (PCC) approaches provide choice and control on when, what and where to eat, encouraging mealtime participation that improves resident QoL, and are considered best-practice [ 12 , 23 , 25 ]. While some facilities attempt to facilitate person-centred mealtimes, dining practices remain largely staff-directed, staff-enhanced dependency is a common RACF phenomenon, and residents are often excluded from decisions or opportunities to exercise autonomy [ 8 , 24 , 26 ]. Resident participation in decision-making and enactment of mealtimes is thus limited by the RACF’s care approach and practices.…”

How Are the Mealtime Experiences of People in Residential Aged Care Facilities Informed by Policy and Best Practice Guidelines? A Scoping Review

“…Conversely, resident factors, including personality differences, health conditions or di culties complying with RACF routines generate negative mealtime experiences and social anxiety . For example, health conditions that affect a resident's eating or swallowing function may require texturemodi ed diets (TMDs) to reduce aspiration and choking risk, but these are known to negatively affect meal enjoyment, calorie intake and QoL ( Despite evidence demonstrating the bene t for residents of mealtime environments that encourage choice and independence, logistical barriers often prevent RACFs from adopting these approaches (Maluf, Cheater et al 2020). Person-centred care (PCC) approaches provide choice and control on when, what and where to eat, encouraging mealtime participation that improves resident QoL, and are considered best-practice ( Government policies and standards that regulate and fund RACFs in uence local RACF practices and processes (Buelow and Fee 2000).…”