I am a Speech and Language Therapist. This is a really varied job, and in my case I have specialised in working with older people. A big part of this has been going into care homes, responding to referrals if a resident is having eating and drinking difficulties. Often the resident has dementia.
The importance of mealtimes

In this course of this work, I have come to realise just how fundamental mealtimes are to health and quality of life. And that good mealtime care is transformational to the experience of people with dementia living in care homes. But I have also learned that mealtime care is a skilled and complex activity, and we can do more to support staff in this.

Better mealtimes through staff training

So I obtained funding from the National Institute of Health and Care Research (NIHR) to do a PhD. My project was to develop a training course about better mealtimes for people with dementia. This involved three different pieces of work. Firstly, a literature review: I looked at relevant research studies and guidelines, to see what current recommendations are. Secondly, an ethnography: I spent time in care homes, observing mealtimes and talking to everyone involved, to find out what the real issues are in practice. Finally, I brought together a group of people with insight and experience, and we used evidence from the literature review and ethnography to create a training course.

There are five topics in the training:

• Choice – helping people feel empowered and able to make decisions about what they want to eat, when they want to eat and where they want to eat.
• Independence – ensuring people are able to eat and drink as independently as possible.
• Social interaction – recognising that mealtimes are often very social occasions, and helping people experience that.
• Safety – making mealtimes are safe occasions, and thinking particularly about people who have swallowing difficulties.
• Nutrition and hydration – supporting residents who are eating and drinking less than usual.

And two guiding principles that bring everything together:

• Understand people as individuals: taking into account their preferences, skills and history.
• Work together as a team: everyone playing their part; carers, family, management, kitchen staff and others.

Sharing good practice in a simple animation

With funding from NIHR and Alzheimer’s Society, we have tested the training in three local care homes, and are currently exploring how to roll it out more widely. But we wanted to be able to share the key messages quickly. So we decided to create an animation – just a small snapshot of the training, but something that would be accessible by many more people.

So I found a local not-for-profit design agency called Roots and Wings, and we worked with a small team to create an animation. The team included care home managers, staff and residents, and other people involved in social care or with experience of the topic. We ran some workshops where we thought about those key points – choice, independence, social interaction, safety, and nutrition and hydration – and came up with clear and accessible ways to communicate them.

You can watch the animation here: A recipe for positive mealtimes.

At the same time, we created a video to show how important it is for researchers and care homes to work together: Making a difference through dementia research.

Thanks so much to everyone who has been involved in this, all the care homes, family carers, health and care staff and other people who have helped with developing the training, testing the training, and creating the animation. If you have any questions or would like to learn more about this work, please do contact me on james.faraday@nhs.net.

James Faraday receives support from the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria, Alzheimer’s Society and NIHR Three Schools’ Dementia Programme, and is funded through a Post-Doctoral Fellowship. The views expressed are those of the author(s) and not necessarily those of the funders, NHS or Department of Health and Social Care.