Food and Nutrition Care in Long-Term Care Facilities: Examining the Perspectives of Frontline Workers

J Nutr Gerontol Geriatr. 2018 Jul-Dec;37(3-4):145-157. doi: 10.1080/21551197.2018.1516593. Epub 2018 Oct 30.

Abstract

Malnutrition in older adults residing in long-term care facilities continues to be a problem in the United States. Existing research has identified a list of possible contributing factors, including staffing problems. Few studies on food and nutrition care have attempted to gain the perspectives of nursing or dietary aides (henceforth, aides), the frontline staff who work most closely with the residents of long-term care facilities. The current study takes a qualitative approach grounded in a theoretical perspective based on Total Quality Management (TQM) to increase understanding of the interpersonal and management practices that affect resident wellbeing, health, and nutrition. Four focus groups (n = 24) were conducted with aides working in long-term care facilities. Aides expressed emotional closeness with residents and provided detailed knowledge about food and nutrition care. They reported both compassion fatigue and satisfaction. An element of dissatisfaction related to aide relationships with management and other employees who did not actively solicit their perspectives and knowledge on resident feeding. The knowledge and experience of aides could be better utilized by shifting management strategies to focus on employee empowerment and training. Principles of TQM could be applied to improve food and nutrition care in long-term care facilities.

Keywords: Compassion fatigue; Total Quality Management; compassion satisfaction; food and nutrition care; long-term care.

MeSH terms

  • Aged
  • Attitude of Health Personnel
  • Female
  • Food Quality
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Long-Term Care* / methods
  • Long-Term Care* / standards
  • Male
  • Malnutrition* / diagnosis
  • Malnutrition* / epidemiology
  • Malnutrition* / prevention & control
  • Nursing Homes / organization & administration
  • Nursing Homes / standards
  • Nutrition Therapy / methods*
  • Quality Improvement / organization & administration
  • Skilled Nursing Facilities* / organization & administration
  • Skilled Nursing Facilities* / standards
  • Total Quality Management / methods*
  • United States