Two systematic reviews undertaken by PenCLAHRC researchers have found that playing music at mealtimes in residential nursing homes is among a range of measures which could result in improved food intake among the elderly and better mealtime behaviour in those with dementia. A thorough analysis of research has identified that introducing changes such as music, wider menu choices or a more pleasant eating environment could also reduce the risk and incidences of malnutrition.
The first systematic review, published in Ageing Research Review, investigated 37 papers on issues relating to the elderly living in residential care. It categorised five types of mealtime intervention: changes to food service; food improvement; dining environment alteration; staff training; and feeding assistance.
The review found that the papers showed some positive effects on food and calorie intake across all types of intervention, especially those addressing the eating environment. However, larger scale trials are required to fully understand which interventions were most effective and why.
The second review investigated the effectiveness of ‘mealtime interventions’ on the behaviour of people with dementia living in care homes. It analysed 11 articles and also categorised interventions into four types: music; changes to food service; alterations to the dining environment; and group conversation. The quality of the studies was poor and only six associated changes to improvement in behaviour, in particular, agitation or aggression.
Again, the review concluded that well-designed, controlled trials are needed to better understand how ‘mealtime interventions’ could be best implemented, and what the long term health benefits might be.
This review was led by Dr Rebecca Whear, who said: “It is no coincidence that both reviews identified evidence to suggest that measures such as music, better menu choice or a pleasant eating environment may improve the overall experience of those in residential care homes, but there is a paucity of quality research on the subject and more work needs to be done if long term benefits are to be achieved.”
Dr Rebecca Abbott, lead author of the first review, said:
“Malnutrition is a major concern in the elderly and those with dementia who are resident in care homes. In 2010 in the UK, 37 per cent of those admitted to a care home within the previous six months were found to be at risk of malnutrition. Across Europe such incidences vary between 36 and 85 per cent. As populations age and residential care for the elderly and those with dementia becomes more widespread, ensuring eating environments that encourage good nutrition and promote enjoyable social contexts are more important than ever. Some interventions would be relatively simple and cheap to implement. To identify the best approaches to this more evidence is needed; good quality long term trials are the next step.”