Characteristics Associated with Relationship-Centred and Task-Focused Mealtime Practices in Older Adult Care Settings
Publication: Canadian Journal of Dietetic Practice and Research
4 April 2024
Abstract
Purpose: To assess care home and staff characteristics associated with task-focused (TF) and relationship-centred care (RCC) mealtime practices prior to the COVID-19 pandemic.
Methods: Staff working in Canadian and American care homes were invited to complete a 23-item online survey assessing their perceptions of mealtime care, with one item assessing 26 potential care practices from the Mealtime Relational Care Checklist (relationship-centred = 15; task-focused = 11) reported to occur in the home prior to the pandemic. Multivariate linear regression evaluated staff and care home characteristics associated with mealtime practices.
Results: Six hundred and eighty-six respondents completed all questions used in this analysis. Mean TF and RCC mealtime practices were 4.89 ± 1.99 and 9.69 ± 2.96, respectively. Staff age was associated with TF and RCC practices with those 40–55 years reporting fewer TF and those 18–39 years reporting fewer RCC practices. Those providing direct care were more likely to report TF practices. Dissatisfaction with mealtimes was associated with more TF and fewer RCC practices. Homes that were not making changes to promote RCC pre-pandemic had more TF and fewer RCC practices. Newer care homes were associated with more RCC, while small homes (≤49 beds) had more TF practices.
Conclusions: Mealtime practices are associated with staff and home factors. These factors should be considered in efforts to improve RCC practices in Canadian homes.
Résumé
Objectif. Évaluer les caractéristiques des établissements de soins et du personnel associées aux pratiques de soins centrées sur la tâche (CT) et sur la relation (CR) lors des repas avant la pandémie de COVID-19.
Méthodes. Du personnel travaillant dans des établissements de soins canadiens et américains a été invité à répondre à un sondage en ligne de 23 questions visant à évaluer ses perceptions quant aux soins offerts aux repas. L’une des questions évaluait 26 pratiques de soins potentielles de la Mealtime Relational Care Checklist [Liste de contrôle des soins relationnels aux repas] (CR = 15; CT = 11) rapportées comme ayant eu cours dans l’établissement avant la pandémie. Une régression linéaire multivariée a permis d’évaluer les caractéristiques du personnel et des établissements de soins associées aux pratiques propres aux repas.
Résultats. Six cent quatre-vingt-six répondants ont répondu à toutes les questions utilisées dans cette analyse. Le nombre moyen de pratiques CT et CR aux repas était de 4,89 ± 1,99 et de 9,69 ± 2,96, respectivement. L’âge du personnel était associé aux pratiques CT et CR, les 40-55 ans déclarant moins de pratiques CT et les 18-39 ans, moins pratiques CR. Les personnes qui prodiguaient des soins directs étaient plus susceptibles de rapporter des pratiques CT. L’insatisfaction à l’égard des repas était associée à plus de pratiques CT et à moins de pratiques CR. Les établissements qui n’apportaient pas de changements pour promouvoir les pratiques CR avant la pandémie comptaient plus de pratiques CT et moins de pratiques CR. Les établissements de soins plus récents comptaient plus de pratiques CR, tandis que les petits établissements (≤ 49 lits) comptaient plus de pratiques CT.
Conclusions. Les pratiques aux repas sont associées à des facteurs propres au personnel et à l’établissement. Ces facteurs devraient être pris en compte dans les efforts visant à améliorer les pratiques CR dans les établissements canadiens.
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Financial support: This research was funded by the Social Sciences and Humanities Research Council, file number 892-2020-0044.
Competing interests: The authors declare that they have no competing interests.
REFERENCES
1
Anderson K, Bird M, MacPherson S, and Blair A. How do staff influence the quality of long-term dementia care and the lives of residents? A systematic review of the evidence. Int Psychogeriatr. 2016;28(8):1263–81.
2
Faraday J, Abley C, Beyer F, Exley C, Moynihan P, and Patterson JM. How do we provide good mealtime care for people with dementia living in care homes? A systematic review of carer-resident interactions. Dementia, 2021;20(8):3006–31.
3
Watkins R, Goodwin VA, Abbott RA, Backhouse A, Moore D, and Tarrant M. Attitudes, perceptions and experiences of mealtimes among residents and staff in care homes for older adults: a systematic review of the qualitative literature. Geriatr Nurs. 2017;38(4):325–33.
4
Keller H, Carrier N, Duizer L, Lengyel C, Slaughter S, and Steele C. Making the most of mealtimes (M3): grounding mealtime interventions with a conceptual model. J Am Med Dir Assoc. 2014;15(3):158–61.
5
Reimer HD and Keller HH. Mealtimes in nursing homes: striving for person-centered care. J Nutr Elder. 2009;28(4):327–47.
6
Fazio S, Pace D, Flinner J, and Kallmyer B. The fundamentals of person-centered care for individuals with dementia. Gerontologist, 2018;58(suppl_1):S10–19.
7
Kitwood T. Dementia reconsidered: The person comes first. 1st ed: Open University Press, Buckingham, England; 1997.
8
Caspar S, Phinney A, Spenceley S, and Ratner P. Creating cultures of care: exploring the social organization of care delivery in long-term care homes. J Long-Term Care. 2020;0:13–29.
9
Dunn H and Moore T. “You can’t be forcing food down ‘em’: nursing home carers” perceptions of residents’ dining needs. J Health Psychol. 2016;21(5):619–27.
10
Røen I, Kirkevold Ø, Testad I, Selbaek G, Engedal K, and Bergh S. Person-centered care in Norwegian nursing and its relation to organizational factors and staff characteristics: a cross-sectional survey. Int Psychogeriatr. 2018;30(9):1279–90.
11
Lucas JA, Carrie Levin BA, Lowe TJ, Robertson B, Akincigil A, Sambamoorthi U, et al. The relationship between organizational factors and resident satisfaction with nursing home care and life. J Aging Soc Policy. 2007;19(2):2007.
12
Hsu AT, Berta W, Coyte PC, and Laporte A. Staffing in Ontario’s long-term care homes: differences by profit status and chain ownership. Can J Aging. 2016;35(2):175–89.
13
Suhonen R, Alikleemola P, Katajisto J, and Leino-Kilpi H. Nurses’ assessments of individualised care in long-term care institutions. J Clin Nurs. 2012;21(7–8):1178–88.
14
Iuglio S, Chaudhury H, Lengyel C, Morrison J, Boscart V, Carrier N, et al. Construct validation of the mealtime relational care checklist for individual resident use in long-term care. J Nurs Meas. 2019;27(3):493–507.
15
Keller HH, Trinca V, Dakkak H, Wu SA, Bovee S, Carrier N, et al. Impact of COVID-19 on relationship-centred residential dining practices. Can J Aging. 2021;40(4): 604–18.
16
Keller HH, Carrier N, Slaughter SE, Lengyel C, Steele CM, Duizer L, et al. Prevalence and determinants of poor food intake of residents living in long-term care. J Am Med Dir Assoc. 2017;18(11):941–7.
17
Lowndes R, Daly T, and Armstrong P. “Leisurely Dining”: exploring how work organization, informal care, and dining spaces shape residents’ experiences of eating in long-term residential care. Qual Health Res. 2018;28(1):126–44.
18
Bourgeault IL, Atanackovic J, Rashid A, and Parpia R. Relations between immigrant care workers and older persons in home and long-term care. Can J Aging. 2010;29(1):109–18.
19
Daly T. Dancing the two-step in Ontario’s long-term care sector: more deterrence-oriented regulation = ownership and management consolidation. Stud Polit Econ. 2015;95(1):29–58.
20
Zimmerman S, Gruber-Baldini AL, Sloane PD, Eckert JK, Hebel JR, Morgan LA, et al. Assisted living and nursing homes: apples and oranges?. Gerontologist, 2003;43 Spec No 2:107–17.
21
Chaudhury H, Keller H, Pfisterer K, and Hung L. Development of a physical environmental observational tool for dining environments in long-term care settings. Gerontologist, 2017;57(6):e95–101.
22
Chaudhury H, Hung L, and Badger M. The role of physical environment in supporting person-centered dining in long-term care: a review of the literature. Am J Alzheimers Dis Other Demen. 2013;28(5):491–500.
23
Chaudhury H, Hung L, Rust T, and Wu S. Do physical environmental changes make a difference? Supporting person-centered care at mealtimes in nursing homes. Dementia (London). 2017;16(7):878–96.
24
Hung L, Chaudhury H, and Rust T. The effect of dining room physical environmental renovations on person-centered care practice and residents’ dining experiences in long-term care facilities. J Appl Gerontol. 2016;35(12):1279–301.
25
Squires JE, Hoben M, Linklater S, Carleton HL, Graham N, and Estabrooks CA. Job satisfaction among care aides in residential long-term care: a systematic review of contributing factors, both individual and organizational. Nurs Res Pract. 2015;2015:157924.
26
Chamberlain SA, Hoben M, Squires JE, and Estabrooks CA. Individual and organizational predictors of health care aide job satisfaction in long term care. BMC Health Serv Res. 2016;16(1):577. Published 2016 Oct 13.
27
Edvardsson D, Fetherstonhaugh D, McAuliffe L, Nay R, and Chenco C. Job satisfaction amongst aged care staff: exploring the influence of person-centered care provision. Int Psychogeriatr. 2011;23(8):1205–12.
28
Dahlke S, Davidson S, Kalogirou MR, Swoboda NL, Hunter KF, Fox MT, et al. Nursing faculty and students’ perspectives of how students learn to work with older people. Nurse Educ Today. 2020;93:104537.
29
Sjögren K, Lindkvist M, Sandman PO, Zingmark K, and Edvardsson D. Organisational and environmental characteristics of residential aged care units providing highly person-centred care: a cross sectional study. BMC Nurs. 2017;16:44. Published 2017 Aug 10.
30
Keller HH, Wu SA, Iraniparast M, Trinca V, Morrison-Koechl J, and Awwad S. Relationship-centered mealtime training program demonstrates efficacy to improve the dining environment in long-term care. J Am Med Dir Assoc. 2021;22(9):1933–8.e2.
31
Wu S, Morrison JM, Dunn-Ridgeway H, Vucea V, Iuglio S, and Keller H. Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term care. BMC Geriatr. 2018;18(1):277. Published 2018 Nov 13.
32
Watkins R, Goodwin VA, Abbott RA, and Tarrant M. Eating well in care homes: testing the feasibility of a staff training programme aimed at improving social interaction and choice at mealtimes. Int J Older People Nurs. 2019;14(3):e12247.
33
Rajamohan S, Porock D, and Chang YP. Understanding the relationship between staff and job satisfaction, stress, turnover, and staff outcomes in the person-centered care nursing home arena. J Nurs Scholarsh. 2019;51(5):560–8.
34
Estabrooks CA, Squires JE, Carleton HL, Cummings GG, and Norton PG. Who is looking after Mom and Dad? Unregulated workers in Canadian long-term care homes. Can J Aging. 2015;34(1):47–59.
35
Bennett MK, Ward E, Scarinci N, and Waite M. Perspectives on mealtime management in residential aged care: insights from a cross-disciplinary investigation. J Nutr Gerontol Geriatr. 2014;33(4):325–339.
36
Lowndes R, Armstrong P, and Daly T. The meaning of ‘Dining’: the social organization of food in long-term care. Food Stud. 2015;4(1):19–34.
37
Smythe A, Jenkins C, Galant-Miecznikowska M, Bentham P, and Oyebode J. A qualitative study investigating training requirements of nurses working with people with dementia in nursing homes. Nurse Educ Today. 2017;50:119–23.
38
Caspar S, Le A, and McGilton KS. The influence of supportive supervisory practices and health care aides’ self-determination on the provision of person-centered care in long-term care facilities. J Appl Gerontol. 2019;38(11):1564–82.
39
Trinca V, Chaudhury H, Slaughter SE, Lengyel C, Carrier N, and Keller H. Making the most of mealtimes (M3): association between relationship-centered care practices, and number of staff and residents at mealtimes in Canadian long-term care homes. J Am Med Dir Assoc. Elsevier Inc.; 2021;22(9):1927–32.
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Published In
Canadian Journal of Dietetic Practice and Research
Volume 85 • Number 2 • June 2024
Pages: 66 - 75
Editor: Naomi Cahill
History
Version of record online: 4 April 2024
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© 2024.
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VanessaTrincaMSc, Sarah A.WuPhD, HanaDakkakRD, MScFN, MaryamIraniparastPhD, AllisonCammerRD, PhD, ChristinaLengyelRD, PhD, Hannah M.O’rourkeRN, PhD, NatalieRoweMID, Susan E.SlaughterPhD, NatalieCarrierPhD, SuzanneQuiringRD, RuthHarvieRD, PhD, and HeatherKellerRD, PhD. 2024. Characteristics Associated with Relationship-Centred and Task-Focused Mealtime Practices in Older Adult Care Settings. Canadian Journal of Dietetic Practice and Research.
85(2): 66-75. https://doi.org/10.3148/cjdpr-2023-023
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