title: Mealtime management in Australian residential aged care: Comparison of documented, reported and observed care.
abstract: OBJECTIVE
  Mealtime management in Residential aged care facilities (RACFs) should be holistic and comply with the principles of person-centred care (PCC) to ensure residents' medical, nutritional and psychosocial mealtime needs are met. However, this is not always achieved and multiple issues with mealtime management in RACFs exist. The aim of the current study was to compare documented, reported and observed mealtime management to explore factors influencing optimal mealtime care.
  
  
  METHODS
  Data were triangulated from: (a) review of 14 resident files; (b) observation of 41 mealtimes; (c) questionnaires with 14 residents; and (d) questionnaires with 29 staff.
  
  
  RESULTS
  Results revealed multiple discrepancies between data sources leading to the delivery of sub-optimal mealtime care. Poor documentation impacted staff knowledge of required mealtime practices resulting in occasions of inconsistent and inappropriate care. Observational and interview data highlighted discrepancies between residents' mealtime preferences and actual practice. In many instances observed care was not holistic nor consistent with PCC.
  
  
  CONCLUSIONS
  Given the significant medical, nutritional and psychosocial risks associated with poor mealtime management, systematic changes in policy, staff training and multidisciplinary care are needed.
authors.affiliation: School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane , Australia.
authors.forename: Michelle Katherine
authors.initials: MK
authors.lastname: Bennett
authors.forename: Elizabeth Celeste
authors.initials: EC
authors.lastname: Ward
authors.forename: Nerina Aimee
authors.initials: NA
authors.lastname: Scarinci
mesh_terms: D001315:Australia; D003625:Data Collection / Q000379:methods; D006707:Homes for the Aged / Q000458:organization & administration / Q000592:standards; D006801:Humans; D062407:Meals; D019370:Observation; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Aged care; dysphagia; mealtime care; speech-language pathology