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Assessment of Food Service Delivery to Elderly Residents in Long Term Care Facilities

by Lengyel, Christina Ola

Abstract (Summary)
The purpose of this study was to assess food service delivery provided to elderly long term care (LTC) residents. The sample was drawn from the 18 LTC facilities located in Saskatoon District Health, Saskatoon, Saskatchewan. The study was conducted in four phases: 1) Menu Analysis; 2) Resident Food Service Satisfaction; 3) Food Service Practices; and 4) Dietary Intakes of the Elderly. The study methodology included a 7-day nutrient analysis of cycle menus of 11 LTC facilities, a food service satisfaction survey (n=205 elderly residents), a LTC survey examining menu planning practices (n=11 LTC facilities), and a 3-day dietary intake analysis (n=48 elderly residents) using weighed and observation dietary assessment methods. LTC facility menus did not meet the recommended levels (<100% Recommended Dietary Allowance; RDA or Adequate Intake; AI) of vitamin E (males & females: 69% RDA), vitamin C (males: 87% RDA), niacin (males: 98% RDA), vitamin B6 (males: 76% RDA; females: 87% RDA), folate (males & females: 47% RDA), magnesium (males: 63% RDA; females: 82% RDA), zinc (males: 80% RDA), calcium (males & females: 84% AI), and vitamin D (males & females: 51-70 yrs, 69%; 70+ yrs, 46%). Energy was 88% Recommended Nutrient Intake (RNI) for males 50-74 yrs. Dietary fibre content was low (14 g/day) for both gender groups. LTC facility menus did not provide the recommended number of servings of vegetables and fruit, and grain products compared to Canada's Food Guide to Healthy Eating. Snacks provided by LTC facilities were nutrient dense, covered the four food groups, but were not consistently offered to all residents. Using the Estimated Average Requirement (EAR) cut-point method and the observation method of dietary assessment, the percentage of subjects below the EAR was used to determine the nutrient adequacy of the group of elderly subjects. The percentage of subjects below the EAR for specific nutrients were: folate (96%), magnesium (96%), zinc (79%), vitamin E (77%), vitamin B6 (73%), vitamin C (46%), niacin (31 %), thiamin (29%), and vitamin B12 (19%), even with the consumption of foods between meals (i.e., snacks). Overall, residents were satisfied with food services provided and quality of life issues to eating. Dissatisfaction was shown by low positive (< 80%) responses to: food quality (75%), variety (70%), taste (75%), and appearance (77%), and awareness of the menu (64%). Lack of autonomy was addressed through low positive responses for food choice (70%) and snack accessibility (73%). To help improve the monitoring of food services delivered to populations at risk for inadequate nutrition, the ROCIE Food Service Systems Model was established from the existing model by Vaden (1980). The ROCIE model consists of five synergistic components: Resources, Outcomes, Controlling Factors, Indicators, and Environmental Context. The model illustrates the dynamic relationship that exists between all of the components of the LTC food service system and provides insight into understanding how LTC food services operate. This model will assist health care providers in understanding the role internal and external factors play in influencing food intake of LTC residents.
Bibliographical Information:

Advisor:Henry, Carol; Zello, Gordon; Whiting, Susan; Stewart, Norma; Berenbaum, Shawna; Massey, Linda

School:University of Saskatchewan

School Location:Canada - Saskatchewan

Source Type:Master's Thesis

Keywords:

ISBN:

Date of Publication:11/25/2008

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