Developing a mealtime intervention to improve the health and wellbeing of care home residents

Abstract

Malnutrition is one of the greatest threats to the health, wellbeing and autonomy of older people, particularly those living in care homes. Whilst the need to improve their nutritional status has long been recognised, how this can best be achieved and whether (and which) interventions are effective at reducing morbidity and improving wellbeing is less clear. This research seeks to address this knowledge gap, building on the recognition that mealtimes have a critical socio-cultural role in the care of older people, both in terms of ensuring adequate nutrition and promoting broader health and wellbeing. This project has been informed by two recently published systematic reviews by PenCLAHRC (Abbot et al., 2013, and Whear et al., 2014), which suggest that simple changes to the mealtime environment (e.g. the style of food service, seating arrangements and the playing of music) can positively influence nutritional outcomes and the behavioural and psychological symptoms of dementia (BPSD). However, the quality of mealtime intervention studies to date has been generally poor due to small sample sizes, lack of randomisation, and inadequate control for confounding factors (including those pertaining to residents, staff and the individual care homes). This project aims to build on care home research, an often neglected area due to the challenges of working with (a) the resident population, who are often physically and cognitively frail, and (b) the care home sector which can involve private businesses, low paid and low valued care professionals with a high employee turnover.