Reimagining Nutrition Care and Mealtimes in Long-Term Care |
| |
| Affiliation: | 1. Schlegel-UW Research Institute for Aging, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada;2. Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada;3. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany;1. Department of Geriatrics, Florida State University, College of Medicine, Tallahassee, FL, USA;2. Department of Medicine, University of Rochester, Rochester, NY, USA;1. Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, USA;2. Department of Industrial and Systems Engineering, University of Wisconsin–Madison, Madison, WI, USA;3. Department of Medicine, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, USA;4. School of Pharmacy – Social and Administrative Sciences Division, University of Wisconsin–Madison, Madison, WI, USA;1. Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada;2. Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;3. Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;4. Baycrest Health Sciences Centre, Toronto, Ontario, Canada;5. Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;6. Division of General Internal Medicine, North York General Hospital, North York, Ontario, Canada;7. Womens College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada;8. Sienna Senior Living Canada, Markham, Ontario, Canada;9. Women''s College Hospital, Toronto, Ontario, Canada;10. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;11. Division of General Internal Medicine and Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health, Toronto, Ontario, Canada;1. Ageing and Health Unit, Department of Maternal, Newborn, Child & Adolescent Health and Ageing, WHO, Geneva, Switzerland;2. Master''s and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil;3. Global Observatory for Palliative Care Institute for Culture and Society University of Navarra, Pamplona, Spain;4. College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia |
| |
| Abstract: | Poor food and fluid intake and subsequent malnutrition and dehydration of residents are common, longstanding challenges in long-term care (LTC; eg, nursing homes, care homes, skilled nursing facilities). Institutional factors like inadequate nutrition care processes, food quality, eating assistance, and mealtime experiences, such as staff and resident interactions (ie, relationship-centered care) are partially responsible and are all modifiable. Evidence-based guidelines on nutrition and hydration for older adults, including those living with dementia, outline best practices. However, these guidelines are not sector-specific, and implementation in LTC requires consideration of feasibility in this setting, including the impact of government, LTC home characteristics, and other systems and structures that affect how care is delivered. It is increasingly acknowledged that interconnected relationships among residents, family members, and staff influence care activities and can offer opportunities for improving resident nutrition. In this special article, we reimagine LTC nutrition by reframing the evidence-based recommendations into relationship-centered care practices for nutrition care processes, food and menus, eating assistance, and mealtime experience. We then expand this evidence into actions for implementation, rating these on their feasibility and identifying the entities that are accountable. A few of the recommended activities were rated as highly feasible (6 of 27), whereas almost half were rated moderate (12/27) and the remainder low (9/27) owing to the need for additional staff and/or expert staff (including funding), or infrastructure or material (eg, food ingredients) investment. Government funding, policy, and standards are needed to improve nutrition care. LTC home leadership needs to designate roles, initiate training, and support best practices. Accountability will result from enforcement of policies through auditing of practice. Further evidence on these desirable nutrition care and mealtime actions and their benefit to residents’ nutrition and well-being is required. |
| |
| Keywords: | Nutrition care malnutrition food mealtimes long-term care |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
