Sharing meals: promising nutritional interventions for primary health care including nursing students and elderly people | BMC Nutrition


This examine explored the experiences from a shared-meal intervention together with nursing college students and aged individuals dwelling at dwelling receiving dwelling care. Our findings are introduced in keeping with the next themes: “improved meal preparation”, “combined meal experiences” and “important experiences contributing to improved dietary standing”. The quotes are numbered and marked with an S (pupil) or an E (aged) to make clear the sender.

Improved meal preparation

Improved meal preparation consists of essential components involving the meal environment and the facilitation and tailoring of the meal and surroundings. Each college students and aged members have been concerned.

Mealtime surroundings

There have been many examples of scholars and aged members making small changes to set a pleasant desk and current the meals in a fantastic means. Every of the participant pairs solved this in a different way. Some college students carried out these actions on their very own, whereas some aged individuals ready their dwelling surroundings alone previous to the shared meal, and in some conditions, the scholars and aged members did this collectively. The meals used on this undertaking have been ready-made meals that required heating:

We eat a meal and facilitate … and ensure her sitting place is nice. We don’t simply say “hello, let’s eat”, however we take into consideration the meal surroundings as properly. S#8

We discovered that the scholars and aged members improved the looks of their meals by placing the meals on good plates and in bowls. They thought this was extra stunning:

The primary time we put the meals straight on the plate, however then we skilled that it was higher to place the meals in trays and serve ourselves. The primary time we did it, she solely had two meatballs and a spoonful of mashed potatoes. I assumed: “Is that this all she is having?” (laughter) However then she helped herself thrice as a result of she preferred it a lot, which was very good. It confirmed that she wished extra meals after we sat and talked, and she or he might assist herself. S#9

Many aged members additionally used tablecloths, napkins, lit candles and adorned the desk with flowers to make the meals and meal state of affairs extra appetizing:

We turned off the radio after we ate. And she or he had already put out some good napkins and a tablecloth and a few flowers. The meals have been very nice. S#4

We did it collectively. I feel she skilled coping and a sense of getting a visitor in the home by setting the desk. S#9

Meals and diet tailoring

Meals and dietary tailoring are essential to regulate the meals and meals to the assorted people’ wants. Though nutritious and tasteful, the ready-made meals weren’t fortified or vitality dense. Prepared-made meals have restricted prospects for individualization, however many college students nonetheless managed to regulate the meals in keeping with the wants of the aged individuals in varied methods, e.g. by bettering the vitality and protein content material and adjusting the portion measurement. The nursing college students ordered the identical meal because the aged members they have been paired with to have the ability to mutually share the style expertise, and the scholars selected meals that they thought the aged particular person can be acquainted with after they skilled difficulties selecting a meal from the menu:

I ordered the identical meals for her and me for us to have one thing in widespread. It’s good to speak in regards to the meals after we eat the identical meal. S#10

I feel it’s helpful for her, me being there consuming together with her. As a result of then we do one thing collectively. S#3

Many nursing college students helped the aged individuals with smaller parts of meals when their urge for food was poor. Smaller parts will be extra appetizing for aged individuals with a decreased urge for food:

Some days her urge for food was poor. I mentioned: “we will share a portion, you and I?” Then she ate a small portion. It was not ideally suited, however higher than nothing. S#3

We had two parts of the identical meal and put the meals on serving plates. Then we might assist ourselves on the desk and the portion can be smaller when urge for food is poor. S#1

The scholars additionally managed to fortify the meals utilizing additional butter, oils, cheese and cream the place acceptable. To reinforce the aged individuals’ dietary consumption, the scholars additionally offered an extra dessert. When the aged individuals had decreased style sensation, the coed used extra herbs and spices with the meal to enhance the aged individuals’ style expertise:

However in fact, we put additional butter within the mashed potatoes, little issues that fortify the meals. S#9

Lots of the aged members have been used to eat prepared meals and have been concerned within the fortification of the meals. The dessert was a optimistic contribution and improved the dietary and vitality content material of the meal:

The aged lady preferred one thing candy following the meal. The final day, I introduced donuts that we ate. She preferred that rather a lot. S#3

She actually appreciated the dessert. She didn’t all the time end the principle meal. She put it apart and saved it for the night, however she all the time managed to complete the dessert. S#10

Atmosphere affecting the meal

We discovered that the scholars tried to create an excellent ambiance for sharing a pleasant meal along with their aged accomplice. Many college students have been involved about empowering the aged members and tried to discover what mattered to them:

I used to be very fortunate. We had an excellent chemistry and it was all very good. I seemed ahead to the meal and thought that is going to be good. I attempted to suppose: “What will be good for this affected person?” S#3

The scholars reported that the aged members expressed elevated coping by making ready a meal collectively. Nonetheless, many college students skilled that the aged members have been content material when the scholars took care of all the sensible wants across the meal:

To her, it was essential to set the desk properly. I used to be a visitor in her home, and she or he wished every little thing to be good and properly introduced. S#9

I can’t handle rather a lot, however I feel I might have carried out greater than I did, however he took care of every little thing. E#3

Blended meal experiences

This theme incorporates experiences regarding combined meal outcomes and the totally different influences of meals corresponding to nutrition-related components and the facilitators and limitations to an excellent meal.

Diet-related components

Some college students reported the meal as a chance to speak to the aged participant about diet whereas others reported the alternative, i.e. the meal was primarily an excellent enviornment for social interplay and to a lesser extent giving direct dietary recommendation. Some aged members agreed that combining consuming and dietary recommendation can be difficult:

I thought of fortification and energy-dense meals, and I talked to the dependents about it…. and it helped as a result of her weight elevated. S#3

We talked about what meals she preferred, and what meals she was used to eat. And we talked about her difficulties consuming and her lack of urge for food. However it didn’t really feel pure for me to inform her: “you could eat this and that is essential.” This stress would destroy the great meal state of affairs that I attempted to create. S#1

The dialog flowed simply. It was not an issue. We talked rather a lot about social issues and talked rather a lot much less about diet. S#4

We talked about every little thing. It felt like we’d recognized one another our entire life. E#3

If an individual got here to me, to eat with me and speak about diet, I wouldn’t like that. E#1

Nonetheless, the scholars demonstrated different oblique methods wherein they used their obtained dietary information via meals fortification, concerns associated to present medical situations and catching up on inappropriate conditions and gear utilized by the aged individuals in the course of the meals:

And he has common plates, however I seen that when he eats, he pushes the meals to the sides of the plate. After which he has issues getting the meals on to the fork. So now I made them (home-care nursing workers) order particular plates to make this simpler. … I don’t perceive why nobody has thought of it already. S#11

Consuming and making ready a meal collectively gave the scholars elevated beneficial perception into the state of affairs of the aged members in contrast with the chances for the home-care nursing workers with their restricted time and sources.

Facilitators and limitations to an excellent meal

Consuming collectively will be an intimate, private expertise. The nursing college students and aged members had many views on the facilitators of an excellent meal. All of them had sufficient time throughout every go to, which was essential for attending to know one another and creating a pleasant ambiance. Most college students and aged members appreciated this second collectively. They talked rather a lot about many various topics, and the scholars mentioned they felt the aged sufferers loved the conversations in addition to the meals:

It was a pleasant approach to handle extra than simply their bodily wants as a result of we had one hour the place we might speak collectively, and in that means, we might handle each social and psychological wants as properly. S#1

My affected person all the time talked about how good it’s to eat collectively. We skilled that it was very helpful for her, and an excellent factor. S#2

I assumed it was very fascinating, I acquired diverse meals, and I acquired to fulfill a pleasant pupil. We hit it off instantly, and I seemed ahead to each time he was coming. E#3

I mentioned to her: “Go to me while you come again, if you’re not too busy along with your boyfriend” (laughter). Good woman, I loved it rather a lot when she got here. E#4

The scholars talked about some essential limitations. One pupil mentioned they needed to finish the undertaking as a result of the aged particular person had an advanced relationship with meals and didn’t sit up for consuming with somebody:

The aged particular person preferred to be visited however discovered it tough that the go to was about meals. She thought the go to was good, and she or he could be very social, however she couldn’t handle to eat along with me. S#1

The scholars talked about totally different limitations to an excellent meal. Some houses have been difficult for creating an excellent urge for food and meal as a consequence of hygienic components, and a few college students felt that it was a tough expertise to enter a non-public dwelling and eat along with somebody they didn’t know. Others acknowledged the aged members as being lonely however felt that they wanted extra actions and to get out of the home as an alternative of sharing a meal. Some members described the intervention interval as being too brief to have the ability to create an excellent relationship:

I frightened about what we have been going to speak about. Did she have clear plates? What’s the cutlery like? I fear about all these items. S#1

I feel they (home-care nursing workers) have been a bit sceptical in regards to the undertaking. I heard that. However I perceive. It isn’t all the time straightforward to let a stranger into the home and share a meal. S#13

Vital experiences contributing to improved dietary standing

A number of components might contribute to improved dietary standing. We divided our findings into urge for food and meal enjoyment, meals consumption and multidisciplinary dietary care.

Urge for food and meal enjoyment

Mealtimes are when many aged individuals felt most lonely and plenty of had difficulties consuming alone. The nursing college students reported that their visits and the shared meals affected the aged individuals’ moods positively and was one thing they seemed ahead to. College students mentioned the home-care nursing workers additionally seen that the meal and go to evidently affected the aged individuals’ temper each earlier than and after every meal. This was reported by each college students and aged:

She has eaten little or no as a result of she has been lonely. Simply consuming with somebody helped her rather a lot as a result of she ate the entire portion after I was there. S#4

I need to get throughout that this can be a undertaking I hope can final, actually. I’ve an incredible impression of it and after I see how glad the affected person is after I keep there, for as little as an hour possibly. S#2

I feel it is extremely optimistic to have somebody to share a meal with. I’ve issues consuming alone, to me it is extremely good to eat collectively as a result of then I handle to eat. E#1

The scholars reported varied different attainable components influencing urge for food and meals consumption. The meals smelled good and plenty of aged members clearly loved the ready meals:

It smelled good each within the kitchen and in the lounge. That may have stimulated the senses. S#4

It was simpler to eat when I didn’t use all my energy in making ready the meal. E#1

Meals consumption

Sharing meals might have affected meals consumption in lots of the aged members as a result of a lot of them talked about it as an element that affected their meals consumption. Many college students reported that their aged sufferers ate the entire portion of meals and a few dessert regardless of having difficulties consuming:

I seen after we talked, he didn’t discover that he eats after which he eats extra. S#6

She loved the meal and ate all of the meals. Despite the fact that the parts have been very huge, she ate every little thing, which was shocking. S#5

Along with improved urge for food and enhanced meals consumption within the aged, many college students reported that their aged sufferers gained weight. This was most likely as a consequence of a mixture of various measures in dietary care:

She had misplaced some weight beforehand after which her weight elevated by 1.5 kg. S#4

I feel it was a mixture of sharing a meal and different measures that elevated her weight. S#2

Multidisciplinary dietary care

Older sufferers’ dietary care consists of many various components and is most profitable with a multidisciplinary group method. The contribution of the nursing college students was beneficial. The scholars interacted with the sufferers and knowledgeable the home-care nursing workers of their observations. This resulted within the constantly bettering and higher tailor-made care of the sufferers:

I discovered it tough to vary something as a result of every little thing is managed by the measures of the home-care nursing workers and the time allotted. However I had many good conversations with the opposite nurses across the dietary state of affairs of the affected person. S#1

There was no weight documented, regardless that there was a hazard of malnutrition. S#9

The elevated care across the meal state of affairs was additionally appreciated by lots of the aged members:

It’s good that somebody got here to eat along with me as an alternative of home-care nursing workers who simply be sure I get sufficient meals. E#1

The aged members had experiences of the home-care nursing workers’s time constraints making co-eating not possible.

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