Mealtimes as Active Processes in long-term care facilities: a Resident Centered Model
This thesis initiates Canadian research into mealtime dependency of people with dementia living in long-term care facilities (LTCFs), using a Grounded Theory approach. Mealtime observations (n = 180) of residents with dementia (n = 20) in Special Care Units, plus in-depth interviews with clinical dietitians (n = 8), registered nursing staff (n = 5) and health care aides (n = 18) working in LTCFs were completed. The Constant Comparison method was used to analyze and conceptualize the data. A substantive theory entitled "Mealtimes as Active Processes in LTCFs: A Resident Centered Model" emerged with three key themes. (1) Each mealtime is a unique process embedded within a LTCF's environment. (2) Residents are central to the mealtime process through their actions (i.e. arriving, eating, waiting, socializing, leaving and miscellaneous distracted activities). (3) Internal (i.e. residents' characteristics) and external (i.e. co-resident, direct care-giving, indirect care-giving, administrative and governmental activities) influences affect residents' actions at mealtimes. In conclusion, optimal mealtime experiences for residents require comprehensive, inter-disciplinary interventions.