Design for Dementia - Helen Hamlyn Centre - Royal College of Art

DINING
Dining and Care:
When food is prepared in an institutional context, the expectations are typically
very low. Food in a hospital or college canteen has to be quick to prepare and cheap
to buy. There is no involvement in the experience of preparing or serving food other
than to choose it from a menu and to briefly thank the stranger who comes to clear
the table. Design in this situation is orientated towards efficiency and service, which
is appropriate in situations that caters almost exclusively for one-off customers.
However, this type of food management system should not be applied to a
care home where long-term residents live in the building and see it as their home.
The design of the food service and dining environment directly impact a person’s
quality of life and the cultural and social aspects of eating. Food service should
have more purpose and not just be seen as a process.
CARE AND FOOD CULTURE
–
1. Report of an Expert
Working Group, Eating
Well for Older People,
The Caroline Walker Trust,
1995, p22
–
2. Philips LR, Van Ort
S.Measurement of
Mealtime Interactions
among Persons with
Dementing Disorders,
Journal of Nursing
Measurement, 1993,
p41-55
A real challenge when caring for people with dementia is to balance
nutritional needs with the cultural enjoyment that food can bring.
A person with dementia can have a poor appetite or lose interest in
food. This can result in weight loss, reduced ability to fight infections,
apathy and impaired levels of concentration. 1 As food and good
nutrition is essential for health, ensuring that residents eat enough
often overrides other considerations.
Mealtimes are a busy time of the day for staff. People with
dementia can often take longer to eat, have trouble with co-ordination
and in some cases have difficulty swallowing. Residents can require
help to be fed or are bed-bound and need food to be brought to them.
It was observed that the activity of feeding another person can often
take up to 40 minutes per resident to ensure the experience is a calm
and enjoyable one. Some residents may need cues to trigger appetite
and help them eat. For example, staff may need to eat with them to
act as exemplar eaters or use gentle verbal reminders to help them
concentrate on their meal. As staff-to-resident ratios are very low in
many homes, care workers report that meal times can be one of the
most stressful parts of their day. 2
Due to these challenges, residents are rarely encouraged to get
involved in preparing meals. Part of this is to do with the structure
and layout of homes and the lack of facilities for running food-related
activities. Food is often prepared in a central kitchen set aside from
the residential area. It is transported to separate serving units within
each section and then distributed. Service areas only include basic
amenities for washing and serving and residents are not allowed into
these areas for reasons of health and safety.
Centralised kitchen set aside from residential area
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