Special ArticleMalnutrition and Mealtime Ambiance in Nursing Homes
Section snippets
The Concept of Mealtime Ambiance
To understand the concept of mealtime ambiance, Nijs et al7 selected, in 2001, 16 homes from a nationwide inventory study in The Netherlands conducting a project to improve mealtime ambiance. The common goals of the 16 projects were (1) to promote well-being of the clients, (2) to diminish the institutional character of the nursing home, and (3) to optimize the established care and treatment. Analyses of the projects revealed 3 strategies in improving meal ambiance :
- 1.
Restaurant (n = 6). The
Mealtime Ambiance as an External Appetite Stimulus
It is well known that food choice and therefore food intake is influenced by a large number of interrelated factors, which can be divided in internal signals (ie, hunger, thirst, satiety, appetite) and external signals (ie, social environment, economics).8 During the aging process the balance between the internal and the external signals seems to shift from predominantly stimulated by internal to external signals. Roberts et al9, 10 showed that in addition to this shift aging is also associated
Quality of Life, Food, and Meals
Quality of life is defined as the result of combining personal resources, control of the environment, personal values, and actual living conditions.17 Food is an integral part of our well-being and quality of life; it extends beyond simply satisfying hunger and providing nourishment.18 Good food is a sensory and psychological pleasure in its own right. Meals may also add a sense of security and meanings, and particular food habits are influenced by religious cultural, social, and emotional
Studies on Improving Mealtime Ambiance and Effects on Nutritional Status and Quality of Life
Only 4 trials on improving mealtime ambiance were detected, before Nijs et al20 started in 2002 with a larger cluster-randomized trial. The 4 previous trials in frail elderly were inconclusive owing to the small sample sizes, limited study duration, or lack of a control group.21, 22, 23, 24 The trial of Nijs et al20 was conducted among 178 residents, willing and able to answer questionnaires (mean age 77 years) in 5 Dutch nursing homes. Within each home, 2 wards were randomized into an
Discussion
Meals served to residents family style could encourage the feeling of having the meal in “normal” company and therefore these residents feel better and eat more compared with residents having their meals by pre-plating services. Thus, most likely an important factor to explain the observed positive effects of meals served family style is the process of social facilitation; the enhancement of behavior owing to the sheer presence of others: the sounds and sights of others doing the same thing.28
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