Development of a Quality of Meals and Meal Service Set of Indicators for Residential Facilities for Elderly

Malnutrition is a problem in residential facilities for elderly. Literature about malnutrition in nursing homes report a prevalence between 19% and 53% depending on population and applied study design. It is estimated that 39% to 60% of the elderly in nursing homes are at risk for malnutrition.

The consequences of malnutrition are numerous and include a decline in functional status and psychosocial wellbeing, increased health care costs and increased mortality, with negative impacts on quality of life.

An important risk factor for malnutrition in these settings is inadequate food intake. Various reasons for this are described in literature, for example: poor appetite, alterations in taste and smell, cognitive and functional impairment, poor oral/dental health, chronic diseases, and polypharmacy. Nevertheless, research has indicated that the specific needs and preferences of the elderly in nursing homes, associated with reasons of inadequate food intake, are not sufficiently met. Nijs et al. described that optimizing meal quality by offering a homestyle environment, choices, a longer time to eat, more dignified mealtime assistance and stimulating independence, can improve food intake.

The optimization of meals and meal service is an important quality improvement target. To guide quality improvement strategies it is essential to gather valid and reliable information. This information can be obtained by the registration of quality indicators.

Although the problem of inadequate food intake in elderly residential facilities is well known, there were no indicators available which could help guide strategies to improve the quality of meals and meal service.

The aim of this study was to develop a content validated set of quality indicators evaluating the quality of meals and meal service in residential facilities for elderly.

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