Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-10T22:32:30.921Z Has data issue: false hasContentIssue false
  • English
  • Français

Shaping nursing home mealtimes

Published online by Cambridge University Press:  13 January 2016

TOVE HARNETT  and
HÅKAN JÖNSON
TOVE HARNETT*
Affiliation:
School of Social Work, Lund University, Sweden.
HÅKAN JÖNSON
Affiliation:
School of Social Work, Lund University, Sweden.
*
Address for correspondence: Tove Harnett, School of Social Work, Lund University, Box 23, 22100 Lund, Sweden E-mail: tove.harnett@soch.lu.se
Get access Rights & Permissions [Opens in a new window]

Abstract

A number of studies stress the importance of positive mealtime experiences for nursing home residents. However, the components that comprise an ideal nursing home meal remain unclear, reflecting the ambiguity of whether nursing homes should be framed as institutions, domestic settings or a type of hotel. In this study, nursing home meals were viewed as situations that the involved parties could continuously modify and ‘work on’. The aim was to analyse how the staff and residents shaped mealtimes by initiating frames and acting according to established social scripts. The study was based on semi-structured interviews with staff and residents and on ethnographic data, consisting of 100 hours of observations at two nursing home settings in Sweden. The analysis revealed how staff and residents interactively shaped meals using institutional, private or restaurant frames. There were three important findings: (a) an institutional meal frame was dominant; (b) there were substantial difficulties in introducing private frames and established private scripts for meals, since such meal versions are personal and not easy to transport into collective settings; (c) successful creation of private or home-like meal situations illustrates an often overlooked skill in care work. Making meals as ‘care-free’ as possible can be viewed as a way to operationalise the goal of providing a non-institutional environment in nursing homes.

Keywords

nursing homesmealssocial scripts
Type
Articles
Information
Ageing & Society , Volume 37 , Issue 4 , April 2017 , pp. 823 - 844
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abelson, R. P. 1981. Psychological status of the script concept. American Psychologist, 36, 7, 715–29.CrossRefGoogle Scholar
Bergland, Å. and Kirkevold, M. 2008. The significance of peer relationships to thriving in nursing homes. Journal of Clinical Nursing, 17, 10, 1295–302.CrossRefGoogle ScholarPubMed
Bland, R. 1999. Independence, privacy and risk: two contrasting approaches to residential care for older people. Ageing & Society, 19, 5, 539–60.CrossRefGoogle Scholar
Chaudhury, H., Hung, L. and Badger, M. 2013. The role of physical environment in supporting person-centered dining in long-term care: a review of the literature. American Journal of Alzheimers Disease and Other Dementias, 28, 5, 491–500.CrossRefGoogle ScholarPubMed
Curle, L. and Keller, K. 2010. Resident interactions at mealtime: an exploratory study. European Journal of Ageing, 7, 3, 189–200.Google Scholar
Damberg, M. 2010. Hur delaktighet blir deltagande – aktivering och äldreomsorgens sociala innehåll [How participation turns into activation – activation and the social content of eldercare]. Äldre i centrum, 24, 4, 28–30.Google Scholar
Desai, J., Winter, A., Young, K. and Greenwood, C. 2007. Changes in type of foodservice and dining room environment preferentially benefit institutionally seniors with low body mass index. Journal of American Dietetic Association, 107, 5, 808–14.Google Scholar
Emerson, R. M., Fretz, R. I. and Shaw, L. L. 1995. Writing Ethnographic Fieldnotes. University of Chicago Press, Chicago.Google Scholar
Evans, B. C., Crogan, N. L. and Shultz, J. A. 2005. The meaning of mealtimes: connection to the social world of the nursing home. Journal of Gerontological Nursing, 31, 2, 11–17.Google Scholar
Fjær, E. G. and Vabø, M. 2013. Shaping social situations: a hidden aspect of care work in nursing homes. Journal of Aging Studies, 27, 4, 419–27.Google Scholar
Gaskill, D., Black, L. J., Isenring, E. A., Hassall, S., Sanders, F. and Bauer, J. D. 2008. Malnutrition prevalence and nutrition issues in residential aged care facilities. Australasian Journal on Ageing, 27, 4, 189–94.Google Scholar
Goffman, E. 1974. Frame Analysis: An Essay on the Organization of Experience. Harvard University Press, Cambridge, Massachusetts.Google Scholar
Gubrium, J. F. 1975. Living and Dying at Murray Manor. University of Virginia Press, Charlottesville, Virginia.Google Scholar
Gubrium, J. and Holstein, J. 1997. The New Language of Qualitative Method. Oxford University Press, New York.Google Scholar
Harnett, T. and Jönson, H. 2014. Sill och potatis till den ena och entrecote till den andra? Individanpassning och likvärdighet på särskilda boenden för äldre [Herring and potatoes for some and tenderloin for others? Equality and individualisation in residential care for older people]. Socialvetenskaplig Tidskrift, 21, 3/4, 246–65.Google Scholar
Hauge, S. and Kristin, H. 2008. The nursing home as a home: a field study of residents’ daily life in the common living rooms. Journal of Clinical Nursing, 17, 4, 460–7.Google Scholar
Hicks-Moore, S. L. 2005. Relaxing music at mealtime in nursing homes: effects on agitated patients with dementia. Journal of Gerontological Nursing, 31, 12, 26–32.Google Scholar
Holstein, J. and Gubrium, J. 2004. Context: working it up, down, and across. In Seale, C., Gobo, G., Gubrium, J. and Silverman, D. (eds), Qualitative Research Practice. Sage, London, 267–82.Google Scholar
Jönson, H. and Harnett, T. 2015. Introducing an equal rights framework for older persons in residential care. The Gerontologist. Published online, doi: 10.1093/geront/gnv039. 22 April, 2015.Google Scholar
Jönson, H. and Watanabe, H. 2013. What is good elderly care in Japan and Sweden? A study of how managers of residential care facilities describe care arrangements. Research Reports in Social Work, School of Social Work, Lund University, Lund, Sweden.Google Scholar
Katz, J. 2001. Analytic induction. In Smelser, N. and Baltes, P. (eds), International Encyclopedia of the Social and Behavioral Sciences. Elsevier, Oxford, 480–84.CrossRefGoogle Scholar
Kayser-Jones, J. and Schell, E. 1997. The effect of staffing on the quality of care at mealtime. Nursing Outlook, 45, 2, 64–72.Google Scholar
Kenkmann, A. and Hooper, L. 2012. The restaurant within the home: experiences of a restaurant-style dining provision in residential homes for older people. Quality in Ageing and Older Adults, 13, 2, 98–110.Google Scholar
Kenkmann, A., Price, G., Bolton, J. and Hooper, L. 2010. Health, wellbeing and the nutritional status of older people living in UK care homes: an exploratory evaluation of changes in food and drink provision. BMJ Geriatrics, 10, 6, 114–27.Google Scholar
Kitwood, T. 1993. Towards a theory of dementia care: the interpersonal process. Ageing & Society, 13, 1, 51–67.CrossRefGoogle Scholar
Kofod, J. and Birkemose, A. 2004. Meals in nursing homes. Scandinavian Journal of Caring Sciences, 18, 2, 128–34.Google Scholar
Lundgren, E. 2000. Homelike housing for elderly people? Materialized ideology. Housing, Theory and Society, 17, 3, 109–20.Google Scholar
Mattsson Sydner, Y. and Fjellström, C. 2006. The meaning of symbols of culinary rules – the food and meals in elderly care. Journal of Foodservice, 17, 4, 182–8.Google Scholar
National Board of Health and Welfare (NBHW) 2011. Bostad i särskilt boende är den enskildes hem. Socialstyrelsen, Stockholm.Google Scholar
National Board of Health and Welfare (NBHW) 2014. Måltidsmiljö inom särskilda boenden och dagverksamheter – Förslag till indikatorer. Socialstyrelsen, Stockholm.Google Scholar
Nijs, K. A., de Graaf, C., Kok, F. J. and van Staveren, W. A. 2006. Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial. British Medical Journal, 332, 7551, 1180–4.Google Scholar
Nolan, M. R., Davies, S., Brown, J., Keady, J. and Nolan, J. 2004. Beyond ‘person-centred’ care: a new vision for gerontological nursing. Journal of Clinical Nursing, 13, 1, 45–53.Google Scholar
Palacios-Ceña, D., Losa-Iglesias, M. E., Gómez-Calero, C., Fernández-de-las-Peñas, C., Cachón-Pérez, J. M. and Gómez-Pérez, D. 2013. Is the mealtime experience in nursing homes understood? A qualitative study. Geriatrics and Gerontology International, 13, 2, 482–9.Google Scholar
Park, N. S. 2009. The relationship of social engagement to psychological well-being of older adults in assisted living facilities. Journal of Applied Gerontology, 28, 4, 461–81.Google Scholar
Peace, S. and Holland, C. 2001. Homely residential care: a contradiction in terms? Journal of Social Policy, 30, 3, 393–410.CrossRefGoogle Scholar
Pearson, A., Fitzgerald, M. and Nay, R. 2003. Mealtimes in nursing homes: the role of nursing staff. Journal of Gerontological Nursing, 29, 6, 40–7.CrossRefGoogle ScholarPubMed
Persson, T. and Wästerfors, D. 2009. ‘Such trivial matters:’ how staff account for restrictions of residents’ influence in nursing homes. Journal of Aging Studies, 23, 1, 1–11.Google Scholar
Philpin, S., Merrell, J., Warring, J., Gergory, V. and Hobby, D. 2011. Sociocultural context of nutrition in care homes. Nursing Older People, 23, 4, 24–30.Google Scholar
Philpin, S., Merrell, J., Warring, J., Hobby, D. and Gregory, V. 2014. Memories, identity and homeliness: the social construction of mealtimes in residential care homes in South Wales. Ageing & Society, 34, 5, 753–89.Google Scholar
Rahman, A. N. and Schnelle, J. F. 2008. The nursing home culture-change movement: recent past, present, and future directions for research. The Gerontologist, 48, 2, 142–8.Google Scholar
Rockwell, J. 2012. From person-centered to relational care: expanding the focus in residential care facilities. Journal of Gerontological Social Work, 55, 3, 233–48.Google Scholar
Ryvicker, M. 2009. Preservation of self in the nursing home: contradictory practices within two models of care. Journal of Aging Studies, 23, 1, 12–23.Google Scholar
Schell, E. S. and Kayser-Jones, J. 1999. The effect of role-taking ability on caregiver–resident mealtime interaction. Applied Nursing Research, 12, 1, 38–44.Google Scholar
Sellerberg, A.-M. 1991. Expressivity within a time schedule: subordinated interaction on geriatric wards. Sociology of Health & Illness, 13, 1, 68–81.Google Scholar
Sidenvall, B. 1999. Meal procedures in institutions for elderly people: a theoretical interpretation. Journal of Advanced Nursing, 30, 2, 319–28.Google Scholar
Simmons, S. F., Osterweil, D. and Schnelle, J. F. 2001. improving food intake in nursing home residents with feeding assistance: a staffing analysis. Journals of Gerontology: Biological Sciences and Medical Sciences, 56A, 12, 790–4.Google Scholar
Speroff, B. A., Davis, K. H., Dehr, K. L. and Larkins, K. N. 2005. The dining experience in nursing homes. North Carolina Medical Journal, 66, 4, 292–5.Google Scholar
St. Clair, R. N. 2008. Social scripts and the three theoretical approaches to culture. Intercultural Communication Studies, 17, 4, 171–83.Google Scholar
Sydner, Y. M. and Fjellström, C. 2005. Food provision and the meal situation in elderly care – outcomes in different social contexts. Journal of Human Nutrition and Dietetics, 18, 1, 45–52.Google Scholar
Tuckett, A. G. 2005. Residents’ rights and nurses’ ethics in the Australian nursing home. International Nursing Review, 52, 3, 219–24.Google Scholar
Verbeek, H., van Rossum, E., Zwakhalen, S. M. G., Kempen, G. I. J. M. and Hamers, J. P. H. 2009. Small, homelike care environments for older people with dementia: a literature review. International Psychogeriatrics, 21, 2, 252–64.Google Scholar
Villarroel, R., Sangra, R., Massaguer, L. and Codina, A. 2012. Assessment of food consumption, energy and protein intake in the meals offered in four Spanish nursing homes. Nutricion Hospitalaria, 27, 3, 914–21.Google Scholar
Wilson, C. B., Davies, S. and Nolan, M. 2009. Developing personal relationships in care homes: realising the contributions of staff, residents and family members. Ageing & Society, 29, 7, 1041–63.Google Scholar