Working with the care homes community to improve mealtimes for people living with dementia

Mealtimes are a fundamental part of life

Spend a moment thinking about some of the major events in your life, or those close to you – maybe a wedding, a big birthday, retirement, a baby’s christening. Almost certainly, these events will have been celebrated by eating, or drinking, or probably both. And now imagine if eating and drinking was difficult for you – and the effect that would have.

Eating and drinking well, and safely, is important for our health, and for our quality of life. Clearly there is a physical aspect to this. Good nutrition and hydration helps us to thrive, and to recover from illness and injury. But as we can see, there are also significant social and emotional aspects to eating and drinking.

Providing care at mealtimes is skilled and complex

I have been working as a Speech and Language Therapist for over 15 years. I’ve spent most of that time working with people who have eating and drinking difficulties, so I’ve seen the consequences of this at first hand. Very often, our team receives referrals from care homes because a person living with dementia is experiencing difficulties at mealtimes. Some people living with dementia may experience particular challenges due to the cognitive element of this condition (such as difficulty recognising food and drink, and reduced range of tastes and preferences). Typically, someone from our team will visit the home and spend time with the person and their carers, to understand the problem and suggest some things that might help.

In the course of this work, I have learned that providing care at mealtimes is very skilled and very complex. I have also wondered whether there are more and different ways we can support care home staff in this – for example, by providing better training. So, I began to develop an idea for a training programme to improve mealtime care for people living with dementia. I wanted to work with residents, care home staff and family carers to identify what is important in mealtime care – and use this knowledge to inform the training.

Working with experts by experience to develop training

In 2018 I was fortunate to receive NIHR funding to take this idea forward as a PhD. Five years later the PhD is finally done! I have learned so much from the care homes community who have partnered in this work, and will always be grateful for their enthusiasm and wisdom. With their knowledge and experience, we have developed a staff training programme which aims to improve the experience of people living with dementia at mealtimes. The training emphasises some key principles, including choice, independence, and social interaction – as well as the importance of tailoring care, and working as a team.

Now, with funding from NIHR and the Alzheimer’s Society, I am going to test out the training and refine it, to make sure it’s fit for purpose. I’ll be delivering it in a range of care homes, and finding out from staff whether it has improved their confidence in providing mealtime care. And whether the format works well in their busy care home environment.

I am being supported in this by a local group of care home staff and residents, and have received a lot of help from the local authority in establishing this. The group was initially located within one care home, but we’ve now been joined by other care homes in the area. At the same time, health and social care professionals are contributing to the group through one-to-one meetings. Our intention is for this to be an inclusive space, where for staff and residents have room to share their views on how we should do the research. We are excited to continue in this way as the project moves forward. If you have any questions or would like to learn more about this approach, please do contact me on [email protected].