This new local program is making mealtime a more positive experience for seniors

A new local program is changing the way meals are served to seniors living in long-term care homes.

Heather Keller, a research chair at the Schlegel-UW Research Institute for Aging, says the goal is to make mealtime a more involved, "positive" experience.

Keller, who is also a Kinesiology and Health Sciences professor at the University of Waterloo, helped create the CHOICE+ program. She joined CBC Kitchener-Waterloo's The Morning Edition to talk about it.

This interview has been edited for length and clarity. 

CBC Kitchener-Waterloo: For many of us, mealtimes at home are a social time. How is that different in a long-term care home?

It's not always like that and especially I think we see post-COVID-19 where we had folks eating in their bedrooms for a period of time and then slowly getting back into dining rooms and they might have been distanced from their neighbours.

It's a quiet time. It's often very task-focused getting the meal done. We saw that certainly before COVID-19, but I think COVID-19 exacerbated that for sure.

So what we're trying to do with CHOICE+ is give the resources and the tools and the space for team members and residents to think about how can you make mealtimes the way we want them to be.

We know that when we do have a pleasurable mealtime, people eat more, their quality of life is better. We all know that about ourselves and obviously for older adults as well, but it's something we're trying to encourage through this program.

CBC Kitchener-Waterloo: How does this program change mealtime for seniors at long-term care homes?

It's been about 20 years in developing this program. It started actually by talking. I was doing some research, talking with older adults in the community about what was important about mealtimes for them as a family.

Out of that came six principles that are the CHOICE principles, for example, connecting. The meals are about honouring our dignity, it's about our identity. Those are actually the letters in the CHOICE program name.

These principles [help us] realize what we're trying to achieve. But rather than a list of, "These are the things you must do", it's trying to equip teams and homes with thinking about, "How do we get there?"

Recognizing we need to empower team members. They know best how to make this a social place. Empower them to see that it's not just a task, it's not a timed thing.

CBC Kitchener-Waterloo: How does making mealtime a group activity, benefit seniors on an individual level?

COVID-19 has shown everybody what not to do when it comes to meals and eating in individual rooms.

In between when I first started getting this concept in my head and the program now, we actually developed some standardized tools to observe the dining room. We use those tools in a very large study across Canada with 32 nursing homes in four provinces.

We showed in that study when a dining room was more of what we call "relationship-centered care," the way that they were doing care is more about the relationship and it wasn't about the task, people ate more.

This actually comes from sociological research too, that it's called "social facilitation." We all eat better when we're eating in a good mood or with people we love and want to be around.

This week is actually the last day of Canadian malnutrition awareness and older adults tend to be vulnerable to not eating enough to stay well. As a person moves into seniors care, they're there because they have many challenges to live on their own and those challenges can lead to poor food intake. We're trying to reverse that in a way.  

CBC Kitchener-Waterloo: Recently, we looked at reports of how drugs were being used in Ontario, such as antipsychotic and anti-anxiety medications. Could something like this have an impact in reducing those prescriptions? 

I think there's absolutely potential. The principles behind CHOICE are making it about the person we're caring for, rather than I'm doing a task to this person.

A lot of times our antipsychotic medications are provided to people because their needs are not being met and it ends up being an expression that we as people, who are caring for them, want to control. They're wandering or they're yelling or they might actually strike out because we're doing something they don't want to have happen to them.

If we are actually reversing that thing about, what do they need? What will support them best? What will lead to meeting their needs in this moment?  Which is what the CHOICE+ program is trying to do in the dining room. It should lead to less use of these medications over time.