In her April Blog, my wife Joy wrote about her Dad, Ray who lived at Wren Hall Nursing Home in Selston, UK.
‘Food was a source of great pleasure to Ray. Having his second Full English Breakfast of the morning or an ice-cream in the afternoon whilst watching the TV, was for him, always a delight, a pleasure and a treat.’
When Ray first arrived at Wren Hall, late one afternoon he had missed afternoon tea. The team though made sure he felt welcome. After five servings of French Toast, it was almost dinner time (or ‘Tea’ as we say). What a result!
I have used the QUIS audit tool* over the years to help us measure the quality of the lived experience of people living with dementia in care settings. Observing a mealtime is very revealing. A mealtime brings into focus so much about a care settings culture of care – it’s leadership, attitude towards freedom and choice, quality of relationships, the ability to go with the flow and how much a place really cares about it making it feel like home.
If you spent some time observing a mealtime, what do you think it would reveal? What would see, hear and feel?
Here’s some good practices I have observed:
- Staff sitting and eating with people.
- Lots of visual cues to make the dining area look it is a place to enjoy a meal.
- The main meal of the day can be the evening meal.
- Sharing a cup of tea at the end of a meal and talking about what we would like to do next.
- Two meal sittings for lunch and dinner to get rid of the ‘rush’ and create a more relaxed feel to the day
- Encouraging people for help to set the tables
- Consider portion size, some people may struggle with large portions, observe how people do, you can always offer more!
- An aperitif for everyone!
And here’s some poor practices I have observed:
- Only verbal, but no visual choice of food
- Drinks already poured into glasses before people arrive to sit down to a meal
- No salt, pepper or other condiments on the table. In some case no tablecloth or cutlery either
- Cutlery too big and heavy for people to use. People resorting to using their fingers or not eating
- Breakfast ‘finishing’ at 10.30am, lunch consisting of three courses beginning at 12.30pm.
- People being taken to lounges from 7.30am, kitchen not being open for breakfast until 8.30am
- Staff talking about people being fed (like animals at the zoo), not being supported to eat or drink
- Treating mealtimes as a task not a massive opportunity for enjoyment and connection.
We would like to think that most people would know what a good and a poor mealtime experience would look, sound and feel like. Inviting to staff to step back and just observe a mealtime is a great learning opportunity that almost compels staff to make changes.
* To find out more about QUIS audits, contact us at firstname.lastname@example.org