Abstract
Introduction: Family members play an integral role when choosing a Residential Aged Care Home (RACH) and most continue to be active participants in their loved one’s care after placement (1,2). Family members can also provide feedback to the RACHs on the quality of services, including meals (3,4). This is especially important when there are cognitive or psycho-social barriers that limit the residents’ capacity to provide their own feedback (5).
Aims: The aim of this study was to explore family members’ experiences with the food and food service offered to their relatives living in RACHs to identify areas important to their satisfaction with the mealtime experience offered.
Methods: Family members were recruited through RACHs and Facebook to complete a Food Service Satisfaction Questionnaire (FSSQ) that was specifically designed for family members. The online questionnaire asked family members to provide responses to 40 items regarding the mealtime experience offered to their loved one. In addition to the questions, respondents were asked if they would like to add any additional comments using a free text box. Text responses underwent content analysis using NVivo to identify common themes.
Results: Participants (n=414) completed the questionnaire between October 2022 - May 2023, resulting in 223 qualitative responses. Four distinct categories emerged.
Meal Quality: Overwhelmingly, family members expressed dissatisfaction with the quality of meals. Temperature was the most common complaint, with taste, texture and appearance frequently discussed. Meals were described as cheap, poorly cooked, soggy, bland, and drowning in gravy.
Choice & Variety: he lack of choice and variety were common concerns, especially for residents who have special dietary needs. The lack of alternatives was noted for residents on texture modified diets and those living in memory support units. Many felt their loved ones were offered no choice, consequently they would bring in food from outside the RACH to increase variety.
Staff & Training: Family members expressed concerns regarding the lack of staff at mealtimes, particularly for residents who required assistance to eat. To compensate, some felt compelled to visit daily to provide support. Many felt the level of staff training, particularly the cook or chef, was inadequate.
Organisational Attitudes: Many family members described management as indifferent and felt their attempts to provide feedback fell on deaf ears. Unreasonably small food budgets and ‘penny-pinching’ were blamed for the poor quality of the meals and lack of staffing. Some felt the aged care providers made promises about the level of care that were never upheld.
Discussion: This cross-sectional snapshot indicates most family members felt the food and food service were lacking in many important areas. Whilst a small number of respondents (n=24) provided positive comments, the remainder expressed disappointment, frustration and outright disgust regarding the mealtime experience offered to their loved one. Additionally, family often felt frustrated with the bureaucracy and powerless to facilitate change.
The Australian Government has implemented a star rating system which is intended to “help older Australians and their families to compare the quality and safety performance of different services” (6). The star ratings are based on compliance, residents’ experience, staffing minutes and quality measures (7). Annually, a limited number of residents at each RACH (10%) are surveyed and, regarding the mealtime experience, asked: “Do you like the food here?”
Despite the rating system being intended to assist consumers in identifying services it remains challenging for families to identify RACHs that provide quality meal and dining experiences. Given how central food is to resident satisfaction, more detailed reporting regarding the food service is warranted.
References:
Wodchis WP, Wilson K, Murray M. Different Quality Dimensions are Associated with Resident and Family Ratings of Overall Quality in Long-Term Care. J Health Adm Educ. 2015;32(2):209-221.
Shippee TP, Henning-Smith C, Gaugler JE, Held R, Kane RL. Family Satisfaction With Nursing Home Care: The Role of Facility Characteristics and Resident Quality-of-Life Scores. Res Aging. 2017;39(3):418-442. doi:10.1177/0164027515615182.
Lopez RP, Amella EJ. Time travel: the lived experience of providing feeding assistance to a family member with dementia. Research Support, Non-U.S. Gov't. Res GerontolNurs. 2011;4(2):127-34. doi:10.3928/19404921-20100729-02.
Aschieri FPP, Barelio SPP, Durosini IPP. "Invisible Voices": A Critical Incident Study of Family Caregivers' Experience of Nursing Homes After Their Elder Relative's Death. Journal of Nursing Scholarship. J NursScholarsh. 2021;53(1):65-74. doi:10.1111/jnu.12610.
Griffiths AW, Smith SJ, Martin A, Meads D, Kelley R, Surr CA. Exploring self-report and proxy-report quality-of-life measures for people living with dementia in care homes. Qual Life Res. 2020;29(2):463-472. doi:10.1007/s11136-019-02333-3.
Australian Aged Care Quality Agency. Quality Standards. Australian Government. http://aacqa.gov.au/providers/residential-aged-care
Australian Aged Care Quality Agency. Quality Standards. Australian Government. http://aacqa.gov.au/providers/star-ratings
Aims: The aim of this study was to explore family members’ experiences with the food and food service offered to their relatives living in RACHs to identify areas important to their satisfaction with the mealtime experience offered.
Methods: Family members were recruited through RACHs and Facebook to complete a Food Service Satisfaction Questionnaire (FSSQ) that was specifically designed for family members. The online questionnaire asked family members to provide responses to 40 items regarding the mealtime experience offered to their loved one. In addition to the questions, respondents were asked if they would like to add any additional comments using a free text box. Text responses underwent content analysis using NVivo to identify common themes.
Results: Participants (n=414) completed the questionnaire between October 2022 - May 2023, resulting in 223 qualitative responses. Four distinct categories emerged.
Meal Quality: Overwhelmingly, family members expressed dissatisfaction with the quality of meals. Temperature was the most common complaint, with taste, texture and appearance frequently discussed. Meals were described as cheap, poorly cooked, soggy, bland, and drowning in gravy.
Choice & Variety: he lack of choice and variety were common concerns, especially for residents who have special dietary needs. The lack of alternatives was noted for residents on texture modified diets and those living in memory support units. Many felt their loved ones were offered no choice, consequently they would bring in food from outside the RACH to increase variety.
Staff & Training: Family members expressed concerns regarding the lack of staff at mealtimes, particularly for residents who required assistance to eat. To compensate, some felt compelled to visit daily to provide support. Many felt the level of staff training, particularly the cook or chef, was inadequate.
Organisational Attitudes: Many family members described management as indifferent and felt their attempts to provide feedback fell on deaf ears. Unreasonably small food budgets and ‘penny-pinching’ were blamed for the poor quality of the meals and lack of staffing. Some felt the aged care providers made promises about the level of care that were never upheld.
Discussion: This cross-sectional snapshot indicates most family members felt the food and food service were lacking in many important areas. Whilst a small number of respondents (n=24) provided positive comments, the remainder expressed disappointment, frustration and outright disgust regarding the mealtime experience offered to their loved one. Additionally, family often felt frustrated with the bureaucracy and powerless to facilitate change.
The Australian Government has implemented a star rating system which is intended to “help older Australians and their families to compare the quality and safety performance of different services” (6). The star ratings are based on compliance, residents’ experience, staffing minutes and quality measures (7). Annually, a limited number of residents at each RACH (10%) are surveyed and, regarding the mealtime experience, asked: “Do you like the food here?”
Despite the rating system being intended to assist consumers in identifying services it remains challenging for families to identify RACHs that provide quality meal and dining experiences. Given how central food is to resident satisfaction, more detailed reporting regarding the food service is warranted.
References:
Wodchis WP, Wilson K, Murray M. Different Quality Dimensions are Associated with Resident and Family Ratings of Overall Quality in Long-Term Care. J Health Adm Educ. 2015;32(2):209-221.
Shippee TP, Henning-Smith C, Gaugler JE, Held R, Kane RL. Family Satisfaction With Nursing Home Care: The Role of Facility Characteristics and Resident Quality-of-Life Scores. Res Aging. 2017;39(3):418-442. doi:10.1177/0164027515615182.
Lopez RP, Amella EJ. Time travel: the lived experience of providing feeding assistance to a family member with dementia. Research Support, Non-U.S. Gov't. Res GerontolNurs. 2011;4(2):127-34. doi:10.3928/19404921-20100729-02.
Aschieri FPP, Barelio SPP, Durosini IPP. "Invisible Voices": A Critical Incident Study of Family Caregivers' Experience of Nursing Homes After Their Elder Relative's Death. Journal of Nursing Scholarship. J NursScholarsh. 2021;53(1):65-74. doi:10.1111/jnu.12610.
Griffiths AW, Smith SJ, Martin A, Meads D, Kelley R, Surr CA. Exploring self-report and proxy-report quality-of-life measures for people living with dementia in care homes. Qual Life Res. 2020;29(2):463-472. doi:10.1007/s11136-019-02333-3.
Australian Aged Care Quality Agency. Quality Standards. Australian Government. http://aacqa.gov.au/providers/residential-aged-care
Australian Aged Care Quality Agency. Quality Standards. Australian Government. http://aacqa.gov.au/providers/star-ratings
| Original language | English |
|---|---|
| Number of pages | 1 |
| Publication status | Published - 24 Jul 2023 |
| Event | Dietitians Australia 2023 National Conference - Melbourne Convention Centre, Melbourne, Australia Duration: 23 Jul 2023 → 25 Jul 2023 |
Conference
| Conference | Dietitians Australia 2023 National Conference |
|---|---|
| Country/Territory | Australia |
| City | Melbourne |
| Period | 23/07/23 → 25/07/23 |
Keywords
- Food service satisfaction
- Aged Care