Optimizing the social and physical ambiance during mealtime in Dutch nursing homes: implementation, evaluation of effect with respect to quality of life, nutritional status, and self-care ability, and nationwide dissemination of results.

Among elderly in Dutch nursing homes there is a high prevalence of malnourishment. Improving the social/ physical ambiance at mealtime has shown to be effective in improving nutritional status, quality of life, and self care ability in somatic and psychogeriatric elderly. Aim of the project is a large scale implementation of improvement of meal services in Dutch nursing homes. The project consists of three phases; 1. Preparation (1 year) Study of organization food service systems in Dutch nursing homes. Examination of successfully implemented ambiance mealtime projects. Meetings of advisory board of nursing home staff. Design of implementation plan in two homes with somatic and in two with psychogeriatric wards. 2. Implementation (2 years) Implementation of plans for optimizing the social and physical ambiance at meal times in somatic wards, followed by implementation in psychogeriatric wards. Evaluation of effect with respect to quality of life, nutritional status (body weight, protein, iron), and food intake of the participating residents. Examination of effect of implementation on organizational aspects such as work load and work satisfaction of nursing staff. 3. Dissemination results (1 year) The results of the implementation studies will be disseminated by means of a) implementation manual distributed among all 327 Dutch nursing homes b) work conference for nursing home staff in the Netherlands c) scientific publications