practical living
Meals for one
Extending person-centred
care to the setting of menus
and mealtimes can improve
residents’ wellbeing and make
everyone involved happier.
By Linda Kilworth
M
ealtimes are a unique opportunity to provide personcentred care. Such care involves consideration of an
individual’s desires, wants, needs and social situation.
Provision of nutritious foods and drinks is an essential component
of care in residential facilities.
It is well documented that appetite reduces with age due to
many reasons, including medications, medical conditions, mood
and poor dentition. However, it is important to maintain adequate
intake, as the consequences of a failure to do so include the
obvious things like malnutrition, poor wound healing, lethargy
and dehydration.
Research shows that person-centred care can have an impact
on quality of care. With increased flexibility in meal location, food
choice and timing, there is an increased ability to meet individual
requirements. Food quality, packaging, crockery and cutlery all
have an impact on an individual’s ability to eat and enjoy their
food and drinks. Ultimately, the one thing that can be applied in all
situations is compassion by staff – helping the individual make the
best of the situation and what is on offer.
Several common complexities characteristic of elderly people in
residential care include:
• Consumption extremes – overeating or not wanting to eat at all
• Not remembering having eaten
• Not eating or drinking despite being encouraged to do so
• Changing food and drink preferences
• Resistance to organisational changes
20 agedcareinsite.com.au
• Difficulty communicating needs
• Dislike of texture-modified foods or thickened fluids
Research by Zafirah Mohd Nor, of Iowa State University in the
US, finds that residents experience better service when they
have an opportunity to select their meal preference. Personcentred care can result in enjoyable mealtimes for the majority
of residents. It follows that staff would find mealtimes more
enjoyable if residents are more satisfied.
Unfortunately, mealtimes at many residential care facilities
tend towards being functional for the institution rather than
personalised for individuals. So the challenge is to provide
nutritious meals that meet government standards, remain within
budget and still cater to individual preferences.
Some organisational challenges include:
• Centrally designed menus, with little input from residents
• Little flexibility in mealtime structure, i.e. location, timing
• Plate service that provides limited opportunity for choice or
alternative options for disliked foods
• Set mealtimes with limited windows for service
• Task-centred and ‘institutional’ dining rooms.
Strategies to help improve nutrition status and provide personcentred care can include things like:
• Initial and regular malnutrition screening
• Initial and subsequent family conferences to identify and modify
nutritional care needs
• Involving residents in the planning and monitoring of
arrangements for food service
• When feeding assistance is required, providing full attention to
the resident and taking time to help at the pace the resident sets
• Implement