After having arranged two workshops and participating the ICCAS conference in Lyon, we organized an open webinar on the 14th of June. The webinar was for researchers, teachers and health and social care professionals working in elderly care. Originally our intention was to organize an open seminar but due to the covid restrictions and a change of project period a webinar proved to be a workable solution. Invitations were delivered through the members´ networks and the ICCAS conference. Invitations included an option to vote for topics and fields of interest and the program was then build on the interests that were most wanted ones.
The first part of the webinar consisted of Danish Breakfast Club studies (2018-2022) presented by Lise Justesen (University College Copenhagen) followed by a Swedish Creating caring places study presented by Anna Sandgren (Linnaeus University) . Both of these studies took place in a nursing home context.
The Breakfast Club study, Hospitable meal practices as rehabilitation strategies in nursing homes, consists of three phases. The first part (2018) included an ethnographic study and baseline measurements after which during the second part (2019) focus was on residents´ food related functionality, quality of life and principals for their involvement in food related activities. Premises were that meals can serve as rehabilitation sites as they involve residents in food related activities and support the overall well-being and functional capacities of the elderly residents. During this phase a Hospitable meals model was used. According to this model meals are seen as provisions, routine and conditional hospitality as wells as unconditional hospitality, disruptive micro elements and platforms for co-creation. During the third part (2021) Dynamic hospitality was implemented as everyday meal practices. Actions research strategy includes development of future-workshops, materials and designs, equipment, cookbook and guides, future-workshops with HCP Experiments, meetings with residents, music at meals, playlist, sensory evaluation of meals and e-data collection. Research data was collected by interviews, observations, observed functional capacity and debriefing notes. After a wide variety of analyses and interesting findings a question “What is a home if you can´t act as a host” was risen and needs of developing future-workshops, materials and designs, equipment, cookbooks and guides came up. Testing of host-guest relations, kitchen involvement, relative involvement and developing and testing a mobile kitchen with nursing home residents were launched.
The Swedish study Creating caring spaces -development of mealtime interventions in nursing homes points out that 50% of the residents in nursing homes are malnourished, 90% of people with dementia develop at some time behavioral and psychological symptoms and the mealtime is a key social focal point and occupies a large proportion of activity during a day. In this study Five Aspect Meal Model (FAMM) was used. This model is originally a tool for developing meal services in restaurants. The Room, the Meeting and Product together form the Atmosphere. The management control system serves as a tool for control and logistics. The aim was to develop interventions that target and expand caring qualities of mealtime environments for people living with dementia and besides this to optimize mealtime environments in nursing homes in a way that support health, QoL and well-being of the residents. Research questions were 1) what the experiences of various mealtime environments from the perspectives of residents are, family members and staff, 2) which intervention has been linked to which outcomes in the research literature focusing on mealtimes in nursing homes, 3) what impact has characteristics of mealtime environments on caring aspects and 4) in what ways are the aspects in FAMM relevant concerning needs and demands of an involuntary guest. This study took place in one nursing home in the southeast part of Sweden. The nursing home was opened in the spring of 2018 and it has nine integrated units with three heads and 130 staff members. Two thirds of 85 residents live with a dementia diagnosis. Method consists of an integrative literature review, both qualitative and quantitative methods based on a Participatory Action Research (PAR) tradition in collaboration with residents, family members and staff. First the clinical practice was described, the feedback from the first step was followed by a dialogue where goals/outcomes were set, and interventions were decided on the evaluation of interventions against the goals/outcomes and in relation to feasibility. Descriptive empirical studies from the perspectives of residents, family members and staff, adaptation and validation of a mealtime observation protocol and development of a manual for clinical use guiding the improvements of mealtime environments in nursing homes as well as development of Five Aspect Meal Model are going on.
The second session of the webinar started with a presentation named Development of healthy food -Healthy and sustainable foods for elderly by Cornelia Witthöft & Mohammed Hefni (Linnaeus University) from Sweden. Food science is widely presented at the university of Linnaeus where research activities cover food chemistry and food composition, functional plant foods for a healthy diet, nutrition policies and sustainability, nutrition and bioavailability and food processing for functional ingredients. Special attention has been focused on the role of legumes in promoting health. Development of ingredients for new legume food, especially those that are folate-enhanced, has been emphasized. Also studies of bread with low GI, clinical intervention studies to enhance gut health and assessment of metabolic effects and identification of dietary biomarkers of legume intake using metabolomics and microbiomics have been carried out. One central aim has been to find sustainable ways to reduce the consumption of meat. To meet current and future societal changes we need interdisciplinary knowledge environments to gather prominent research, education, and collaboration.
The last presentation was by Kai-Victor Myrnes-Hansen (University of Stavanger, Norway) whose topic was Elderly and meal knowledge. He covered the impact of color of porcelain, how presentation can increase appetite, and knowledge of food can promote healthy life. Fridge stories vividly illustrated, how just one look into the fridge can reveal the state of the eating and meals of an elderly person living at home. The presentation covered the relations of good food, good health and good economy and rose the question what´s next. We need to figure out how we can join forces, increase cross-sectional research, develop education and the care to the best for the elderly and find out what it is, what they want.
Presentations rose questions and vivid conversation. Topics varied from theory and models to settings and methods, even to new ways of pizza baking. It seems that the network needs people outside universities, people who can put the scientific findings into action in the so-called real life. We are missing and inviting practitioners, such as nurses and social workers as well as service entrepreneurs and producers to join the network. Based on what was heard and learned it is interesting to head towards planning future actions in the Fall.
The project is funded by Nordic Joint Committee for Agricultural and Food Research.
Text: Sari Ranta, Xamk
Picture: Manu Eloaho, Xamk