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A mixed-methods needs assessment was conducted in an urban senior center serving lower-income seniors in Toronto, Ontario, to determine whether they should offer a congregate meal program. Methods included three focus groups with participants (n = 31), a focus group with staff (n = 8), a center-wide survey (n = 36), and a community scan of programs in the area. Interviews with five coordinators at other seniors' centers who offered meal programs were also used to gauge interest and assist with program development. The results of these activities supported offering a twice weekly lunch program with user fees. Over a 6-month pilot period, process evaluation was conducted, comprising observations, record review, and focus groups with participants (n = 9) and staff/volunteers (n = 7) to examine delivery, usage, and costs. Results indicated that the program was well-received and affordable, and that demands on staff were reasonable when a facilitator with culinary training was available. The lessons learned can be used to guide other senior centers in developing and evaluating congregate meal programs.

Montessori-based activities use a person-centred approach to benefit persons living with dementia by increasing their participation in, and enjoyment of, daily life. This study investigated recreation staff and multidisciplinary consultants' perceptions of factors that affected implementing Montessori Methods for Dementia™ in long-term care homes in Ontario, Canada. Qualitative data were obtained during semi-structured telephone interviews with 17 participants who worked in these homes. A political economy of aging perspective guided thematic data analysis. Barriers such as insufficient funding and negative attitudes towards activities reinforced a task-oriented biomedical model of care. Various forms of support and understanding helped put Montessori Methods for Dementia™ into practice as a person-centred care program, thus reportedly improving the quality of life of residents living with dementia, staff and family members. These results demonstrate that when Montessori Methods for Dementia™ approaches are learned and understood by staff they can be used as practical interventions for long-term care residents living with dementia.

Purpose: Few questionnaires to test nutrition knowledge and attitudes of older adults living independently in the community have been developed and tested to assess self-management tools such as Nutri-eSCREEN and other education programs. This study is a first step in the development of a questionnaire designed to evaluate the nutrition knowledge and attitudes of independent older adults (NAK-50+)., Methods: The steps involved in this study were: (i) drafting initial questions based on the content of the Nutri-eSCREEN education material, (ii) using cognitive interviewing to determine if these questions were understandable and relevant (n = 9 adults ≥50 years of age), and (iii) completing test-retest reliability in a convenient community sample (n = 60 adults ≥50 years of age). Intra-class coefficients (ICC) and kappa were used to determine reliability., Results: A 33-item questionnaire resulted from this development and analysis. ICC for the total score was 0.68 indicating good agreement and thus initial reliability., Conclusions: NAK-50+ is a face valid and reliable questionnaire that assesses nutrition knowledge and attitudes in independent adults aged ≥50 years. Further work to determine construct validity and to refine the questionnaire is warranted. Availability of the questionnaire for this age group will support rigorous evaluation of education and self-management interventions for this segment of the population.

Poor food intake in residents living in long-term care (LTC) homes is a common problem. The mealtime experience is known to be important in the multifactorial causes of food intake. Diverse interventions have been developed, implemented, and/or evaluated to improve the mealtime experience in LTC; it is possible that multicomponent interventions will have a greater benefit than single activities. To identify the range of feasible and potentially useful interventions for including in a multicomponent intervention, this scoping review identified and summarized 58 studies that described and/or evaluated mealtime experience interventions. There were several randomized controlled trials, although most studies used less rigorous methods. Interventions that are multicomponent (e.g., food service, dining environment, staff education) and target multilevel factors (e.g., residents, staff) in LTC appear to be feasible, with a variety of outcomes measured. Further research is still needed with more rigorously designed studies, confirming effectiveness, feasible implementation, and scaling up of efficacious interventions.

Factors that influence the menu planning process in Ontario long-term care (LTC) homes were studied, as were key informants' perspectives on how this process could be improved to promote resident-centred menus. Key informants were interviewed by telephone to obtain qualitative data through standardized open-ended questions. The key informants (n=35) were randomly selected nutrition managers of Ontario LTC homes. Selected registered dietitians from the Ontario Long-Term Care Action Group also participated (n=5). Descriptive thematic analysis was completed on data provided. Three over arching themes emerged from the data as drivers in the menu planning process: resource limitations, Ontario Ministry of Health and Long-Term Care standards, and the accommodation of diverse and evolving preferences. Challenges involving resources include insufficient food labour and raw food funding, the workload involved with altering menus, and providing food items for special diets or preferences. In terms of ministry standards, participants reported barriers to complying with rotation and portion standards. Other common obstacles within LTC homes include accommodating personal preferences, cultural preferences, and therapeutic diets. Ontario LTC homes face numerous challenges in the planning of menus for residents, regardless of a home's size, location, or profit status. Suggestions are aimed at improving the menu planning process and providing high-quality, palatable, and culturally appropriate food in these homes so that menus are resident-centred.