An investigation of food provision and consumption in a care home setting

Abstract

Background: Malnutrition and dehydration are life-threatening conditions affecting a large proportion of the elderly community in care homes. Despite the provision of guidelines aimed at ensuring the nutritional requirements of individuals are met, the prevalence of malnutrition remains particularly high in institutionalized older adults. This article describes a study carried out in one Scottish care home to assess food and fluid provision and consumption among care home residents and also identify the contribution different eating occasions make to food intakes. Participants: Participants for the study were recruited from a private long-term care home facility in the Edinburgh locality. Individuals receiving palliative treatment were excluded from this study. Participants needed to reside full time at the nursing home for inclusion to the study. Study Design: Cross-sectional observational study (case study) to determine food provision and also food consumption of care home residents. Dietary intake of each participant was recorded and analyzed for a 24 hour period using plate-wastage methodology. All foods and fluids throughout the day were weighed using calibrated scales (1.0 g) both before foods were served to residents and any leftovers were weighed following consumption. Foods were recorded as per each eating occasion, namely breakfast, lunch, evening meal and also any snacks or drinks. Estimated energy, fluid and macronutrient content of the food provided and consumed was estimated using Windiets dietary analysis software (2005) and then compared to FSA Guidelines (FSA 2007) using one sample t-tests (P < 0.05 indicated statistical significance). Results: Food provision and consumption for a total of 25 residents was measured (n = 3 males: n = 22 females); mean (SD) age 86(8) years. There was no significant difference between energy provided (mean SEM) 2001 59 kcal compared with recommended provision 1955 kcal (FSA, 2007). However, significantly less energy than recommended (mean SEM) (163472 kcal) was consumed (P < 0.01). More than 95% of snacks provided were consumed, as a result these contributed an equivalent proportion to overall energy intake as breakfast and lunch, but these were not rich in protein. Conclusion: Provision of food and fluids within the care home meets FSA guidance, but residents tended to consume significantly less than what was provided thus nutritional deficiencies may exist. Further investigation into snack provision is warranted