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ABSTRACT
This qualitative study describes how Chinese elders in an American nursing home perceived their food and mealtime experiences. Data collection included 20 meal observations and interviews with 7 residents, 9 family members, and 17 staff members. Field notes and interviews were coded and analyzed using an iterative approach similar to grounded theory. All participant groups described institutional food and meals as individualized, nutritious therapy for medical illnesses. Mealtimes lacked sociability and sharing, and although family members provided Chinese food, they did not eat with residents. Residents generally did not consider the institution's effort to provide an "Asian diet" of hot tea and juk (rice porridge) to be Chinese food. These findings suggest that, for these Chinese elders, the biomedicalized, individualized food service and mealtime caregiving practices stripped food of its meaning as a social, shared mealtime experience with family. Nursing professionals and researchers should understand that provision of culturally competent mealtime care for ethnic (Chinese) long-term care residents involves important food service practices in addition to kinds of food.
Food and the social ritual of mealtimes have multiple layers of meaning, including life-giving nutrition, comfort, caring, celebration, and family ties. Poor intake among institutionalized elders places them at risk for malnutrition, so it is imperative that the factors that influence residents' eating behaviors are understood. This study sought to describe how Chinese elders experience their food and mealtimes in nursing homes, and which values- whether Western biomedical or Chinese cultural-are important in how they interpret nursing home food and meals.
LITERATURE REVIEW
Meanings of Food in Nursing Homes
Kayser-Jones' research on nursing staffs' feeding practices with residents of multiple ethnicities identified unskilled feeding as a lack of individualized care. Caregivers did not tailor care to the specific needs of residents unable to feed themselves independently, resulting in higher risk for malnutrition and poorer quality of life (Kayser-Jones, 1996, 1997, 2001; Kayser-Jones, Schell, Porter, Barbaccia, & Shaw, 1999).
The theoretical perspectives of individualism and reductionism underlie the values of medical culture that shape how the lived environment of a traditional nursing home is structured and how the myriad daily practices of caregiving are regulated. Medical culture values the scientific truth that is found through reduction of complexity. For example, physicians are trained to translate...