UWL: Dining Environment 2009
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
UWL: Dining with Others
The Registered Dietitian (RD) should collaborate with other health care professionals and administrators to encourage all older adults to dine with others rather than dining alone. Research reports improved food intake and nutritional status in older adults eating in a socially stimulating common dining area.
UWL: Improvement of Dining Ambience
The Registered Dietitian (RD) should collaborate with other health care professionals and administrators to promote improvement of dining ambience. Research indicates that improvements in physical environment and atmosphere of the dining room, food service and meals, and organization of the nursing staff assistance may result in weight gain in older adults.
UWL: Creative Dining Programs
The Registered Dietitian (RD) should encourage creative dining programs for older adults. Research indicates that dining programs, such as buffet-style dining and decentralization of food service, demonstrate improvements in food intake and/or quality of life.
Risks/Harms of Implementing This Recommendation
Conditions of Application
- Dining with others, improvement of dining ambience and creative dining programs are important components of person-centered care.
- Facility layout may limit application of these recommendations.
Potential Costs Associated with Application
- Improvement of dining room ambience may involve design and construction costs.
- The implementation of creative dining programs may result in increased food and labor costs.
- Nine studies were evaluated regarding dining environment in older adults.
- Three studies report improved food intake and nutritional status in residents eating in a socially stimulating common dining area (Simmons and Levy-Storms, 2005; Wright et al, 2006; Xia and McCutcheon, 2006).
- Two studies focusing on improved dining ambience (such as physical environment and atmosphere of the dining room, food service and meals, and organization of the nursing staff assistance) resulted in resident weight gain (Mathey et al, 2001; Mamhidir et al, 2007).
- Two studies based on creative dining programs (such as buffet-style dining and meal portioning on resident floors) demonstrate improvements in quality of life and/or food intake (Shatenstein and Ferland, 2000; Remsburg et al, 2001).
- Studies of longer duration in residents with different levels of illness acuity are needed.
Recommendation Strength Rationale
- Conclusion Statement in support of this recommendation received Grade II
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
Mathey MF, Vanneste VG, de Graaf C, de Groot LC, van Staveren WA. Health effect of improved meal ambience in a Dutch nursing home: A one-year intervention study. Prev Med. 2001; 32(5): 416-423.
Remsburg RE, Luking A, Baran P, Radu C, Pineda D, Bennett RG, Tayback M. Impact of a buffet-style dining program on weight and biochemical indicators of nutritional status in nursing home residents: A pilot study. J Am Diet Assoc. 2001; 101(12): 1,460-1,463.
Shatenstein B, Ferland G. Absence of nutritional or clinical consequences of decentralized bulk food portioning in elderly nursing home residents with dementia in Montreal. J Am Diet Assoc. 2000; 100(11): 1,354-1,260.
Simmons SF, Levy-Storms L. The effect of dining location on nutritional care quality in nursing homes. Journal of Nutrition Health and Aging. 2005; 9: 434-439.
Simmons SF, Lam HY, Rao G, Schnelle JF. Family members' preferences for nutrition interventions to improve nursing home residents' oral food and fluid intake. J Am Geriatr Soc. 2003; 51: 69-74.
Stroebele N, De Castro JM. Effect of ambience on food intake and food choice. Nutrition, 2004; 20: 821-838.
Wright L, Hickson M, Frost G. Eating together is important: Using a dining room in an acute elderly medical ward increases energy intake. J Hum Nutr Diet. 2006; 19(1): 23-26.
Xia C, McCutcheon H. Mealtimes in hospital: Who does what? Journal of Clinical Nursing. 2006; 15: 1,221-1,227.
Mamhidir AG, Karlsson I, Norberg A, Mona K. Weight increase in patients with dementia, and alteration in meal routines and meal environment after integrity promoting care. J Clin Nurs. 2007; 16(5): 987-996.