Suppor&ve

Dining Environments May Posi&vely Inuence the Nutri&onal Status

and Quality of Life of those Living with Demen&a in Long-Term Care Facili&es
L. Cole, BS, Diete4c Intern & K. McComb, MS, RD, CDN
The Sage Colleges, Troy, NY
Introduc)on
! ~ 90% of pa4ents with demen4a will be
ins4tu4onalized prior to death.2
! Costs es4mated at $604 billion per year and are
expected to increase.1
! With the aging popula4on, demen4a will become a
more prevalent health issue in our society.
! Low food and uid intake is common. In a study
including 45 long-term care facili4es, results showed
that 54% of the residents had low food intake and 51%
had low uid intake.3

Objec)ves
! To assess the dining environment in a long-term care
facility caring for those with demen4a.
! To determine environmental modica4ons which
could improve food intake and health of those with
demen4a.

Methods
! Observa4ons were held over ve days in two demen4a
unit dining rooms following the Dignied Dining Checklist.4
! Inspected environmental characteris4cs, including
aspects of ligh4ng, noise level, table design, and
tableware.
! Observed meal 4me service and resident behavior in
two demen4a unit dining rooms over the span of ve
days. Observed each meal of the day (breakfast, lunch,
and dinner) for at least 15 minutes in each dining room.
! Reviewed history of weight loss concerns over the past
year on these units.

! Results showed that 31% of dining room A and 37.5% of

dining room B met recommended demen4a dining room
characteris4cs.

! 32 dining room characteris4cs were evaluated in each

dining room in regards to ligh4ng, noise, table design &
tableware, mugs, cups, cutlery, and gardens.
Table 1. Dignied Dining Checklist: Evalua4on of two demen4a unit dining
rooms (A and B) to see whether the dened characteris4cs were present (Yes)
or not present (No).
A

LIGHTING
Natural ligh4ng
Contras4ng colors among tabletops and
tableware
Color contras4ng walls/dcor
High gloss oors avoided
Reduced glare
Mesh window shades installed
NOISE
Residents sipng near service pathways is
avoided
Overall noise level appropriate
Noise absorbing surroundings present

No
No

No
No

No
No
No
No

No
No
No
No

No

No

No
No

Yes
No

Carpet oors
Curtains
Wall coverings
Table cloths and pads on table tops
MUGS
Large handles, dark interiors avoided
Wide opening at top
Appropriate weight
CUTLERY
One utensil is oered at a 4me for later-stage
demen4a

No
No
No
No

No
No
No
No

No No
Yes Yes
Yes Yes
No

No

TABLE DESIGN & TABLEWARE

Solid colored table tops
Table contrast at the edges
Colored plates
Adap4ve equipment available
Occupa4onal therapy available
Mugs have large handles, lightweight, light
colored
Chairs are contras4ng in color
All chairs have arms
Too highly contras4ng colors are avoided
Dcor is relevant to the dining experience
CUPS
Not plas4c
Not sippy cups
GARDENS
Gardens are provided to simulate food
recogni4on
Residents are engaged in gardening
Coordinated garden therapy with the dining
program
Mugs have large handles, lightweight, light
colored
Chairs are contras4ng in color
All chairs have arms

Pie Chart 1. Percentage of

characteris4cs (outlined in
Table 1) present in Dining
Room A.

Yes

Yes
Yes
No
Yes
Yes
No

Yes
Yes
No
Yes
Yes
No

Recommenda)ons

Yes
No
Yes
No

Yes
Yes
Yes
No

Yes
Yes

Yes
Yes

No

No

No
No

No
N0

No

No

Yes
No

Yes
Yes

! Paint walls/trim/doors contras4ng colors

! Increase natural ligh4ng
! Add soa materials to room to absorb noises
! Add plants/nature to dining room
! Provide soothing music at meal 4mes
! Use high-contras4ng colored dishes
! Floors should not have a high-gloss nish
! Try to place tables away from serving pathways

Conclusion
! Implemen4ng recommended changes would increase
dinnerware costs; however, these changes may result in:
Improved nutri4onal
Improve behavior
status
Improved nursing home
Improved quality of life recogni4on and
Posi4vely impact sta
reputa4on
Decrease wounds

90
80

Key
Dining
Room A

60
50

Dining
Room B

40
30
20
10
0

Ligh4ng

Noise

Table Design

Mugs

Cutlery

Cups

Gardens

No

Pie Chart 2. Percentage of

characteris4cs (outlined in
Table 1) present in Dining
Room B.

100

70

Key

Bar Graph 1. This graph represents the percentage (y-axis) of the domain from the
Dignied Dining Checklist (x-axis) that was sa4sed in each demen4a dining room.

Percent

! 35.6 million people were living with demen4a in 2010.1

Results (Con)nued)

Results

References
1.

World Health Organiza4on. 10 Facts on Demen4a. World Health Organiza4on. hep://www.who.int/features/facfiles/

demen4a/en/. Published April 2012. Updated 2014. Accessed on November 29, 2014.

2.

Edwards NE, Beck AM, Lim E. Inuence of Aquariums on Resident Behavior and Sta Sa4sfac4on in Demen4a Units. West J
Nurs Res. 2014. doi:10.1177/0193945914526647.

3.

Reed PS, Zimmerman S, Sloane PD, et al. Characteris4cs Associated With Low Food and Fluid Intake in Long-Term Care
Residents With Demen4a. The Gerontologist. 2005;45(1):74-80.

4.

DeBronte C, Wasniski B, Finney S, et al. Dignied Dining: A guide to enhance dining experience for residents living with
demen4a. Morrison Senior Living.