Nutrition Matters September 2015 – The Dining Room Environment

There’s no doubt mealtimes are important. This is the main time residents are able to consume food and fluids to provide nourishment that is vital to their health and well being. Remember that for most residents, a facility’s menu provides 100% of their daily food intake. Many residents look forward to meals as an opportunity to make some of their own decisions (such as what and how much to eat) and get pleasure from social interaction with other residents and staff. The atmosphere in the dining room also influences the residents’ enjoyment of their food. It is of course very important to serve both delicious and nutritious meals, but if the dining room environment is not set up appropriately, this can hinder oral intake and lead to wastage of meals. Read on to find out the factors that can affect the dining room setting and what you could do to help improve your dining room.

Furniture and Layout

In general, dining rooms should be easily accessible to residents. In many cases they are the heart of the facility (just like in your home), so having dining rooms in a convenient location will ensure residents can access it easily without having to go very far to have a meal. It will also mean that visitors feel welcome to stay during meal times.
There should be enough furniture to make the dining room cosy, but not too much that it appears cluttered. Tables and chairs should be placed so that there is still plenty of space for residents to independently seat themselves and enough space for staff to move around to serve residents, as well as seating space for assistance at the table. Four wheel frames should be moved out of the dining room once a resident is seated.
The height of the tables and chairs might also need to be considered. A comfortable height to eat at can vary from person to person and this can affect a persons ability to easily reach and have their meal. Consider having available height adjusting chairs or using cushions to elevate residents who are not able to reach their meals. Wheelchairs and tub chairs also need space, and ideally residents in these chairs should also be seated at a table. What happens in your dining room?

Lighting

The dining room will be more appealing if it is well lit. Having better lighting can also ensure safety for residents and staff and enhance the appearance of food. Natural lighting from skylights and windows is always preferable, but additional lights can be turned on if there is not enough natural light. On sunny days or the late afternoons, glare can be a problem, especially for those with vision impairment, and windows with sheer blinds/curtains could help to minimise this.

Table Setting

Decorate tables with flowers, ornaments and place-mats. You can vary this for different occasions or seasons. Salt and pepper shakers should always be available for residents to use. However, you may need to consider minimising distractions like these for residents with dementia. Ensuring contrasting colours in your table setting can also assist spatial awareness for residents. This could be as simple as using a different coloured place-mat under the plate, to guide residents’ eyes to their plate and assist your residents with being able to independently consume their meal.

Noise

Extra noise can be unpleasant and distracting for those who have trouble concentrating while eating. Whilst it is convenient for the kitchen to be close to the dining room, kitchen noise can impact on the dining room atmosphere. Kitchen noise can be limited by closing doors and turning off kitchen radios during mealtimes. Televisions within the dining area ideally should be turned off unless residents have specifically requested to watch it. Instead, try having soft music playing in the background. This can provide a relaxed atmosphere for the residents and staff, and can also encourage conversation. Think about what you would expect at a restaurant.

Ambience and Environment

Staff should be encouraged to interact in a positive manner with residents during meal times. Staff can explain what is being served and offer encouragement and prompting as required. Ensure your environment is one where residents do not feel rushed, and instead feel comfortable asking for seconds. Ensure residents are allowed enough time to complete their meals and have courses served separately, which may assist in avoiding confusion for residents with dementia.
Avoid having medication trolleys going around during the meal as this can be distracting, is non home-like and can lead to poorer appetites. Aim to provide medications at least 20 minutes before or after meals.

Temperature

Room temperature is important for enjoyment of eating. Protect the area from drafts and have adequate heating, cooling and ventilation, when required.

Assistive Cutlery and Utensils

Does your facility have assistive cutlery and utensils that are available for residents to use if required? Items such as built-up or angled cutlery, plate guards, double handled cups and rubber place-mats can assist in allowing residents to maintain independence with eating and drinking.

Eating Outdoors

Outdoor eating can change the routine and provide a chance for residents to get sunlight exposure for Vitamin D (which assists in the absorption of calcium, which is important for strong bones). Outdoor settings can be used for special events such as residents’ birthdays, Melbourne Cup lunch or other celebrations such as a monthly BBQ. But keep in mind that when UV light and heat are strong to use a shaded area.

Empty plates, cutlery, tablecloth on white table for dinner.

 

 

 

 

 

 

 

 

 

Vision Impairment and the Dining Room

A large percentage of residents in aged care will have a level or form of vision impairment. Consider having cutlery, plates, place-mats, tables and carpets of contrasting colours so that residents are able to distinguish between items in the dining room. A plate of pasta in white sauce can actually disappear into a white plate, sitting on a white tablecloth. Red or blue plates can ensure food components are contrasted to the plate and also to the table cloth. Coasters for clear cups can also provide some visual guidance as to the location of the cup. Stick to plain linen and carpets as patterns or dots can be confusing and even appear like bugs to people with vision impairment and/or dementia.

Are there improvements that can be made in your dining room/s? When planning any changes, asking for residents’ input can be very valuable to enhancing dining room experience.

Your dietitian and occupational therapist can also assist in providing additional strategies and information!