Abstract
Background: Adequate dietary fibre intake prevents constipation in older adults living in residential care. However, dietary fibre consumption in residential care is commonly low and constipation is more often managed with laxatives. Research Objective: To qualitatively explore the views of aged care residents and New Zealand registered dietitians on the provision and consumption of dietary fibre in residential care.
Methods: Adults > 65 years old from four care facilities were approached in September 2022. Each resident was interviewed using standardized open-ended questions. Interviews were recorded and transcribed. Dietitians working with residential care facilities were invited by email to complete an anonymous online survey between June and September 2022. The survey included 34 multichoice and free text questions. Quantitative data were reported as means, standard deviations and percentages. Qualitative data were summarized descriptively and themes were determined inductively.
Results: Nineteen residents (87±8 years; 58% female, 63% rest home level of care) were interviewed, response saturation was reached after 15 interviews. The following themes emerged; there is a high acceptance and willingness to eat more fibre-containing foods but the opportunity is lacking as these foods are not served. Fourteen dietitians completed the survey; 64% had >5 years of experience, 85% provided food service advice and 85% provided clinical services. The following themes emerged; "food-first" constipation management is preferred to laxative use, provision of dietary fibre is less than that planned on the menu, and residents are unlikely to eat high-fibre options.
Discussion: This qualitative study suggests that older adults in residential care desire provision of higher-fibre foods but dietitians do not think residents are likely to eat high-fibre options. Dietitians suspect that while the menu plans to provide adequate dietary fibre, menu changes made by kitchen staff, for reasons unexplored, mean that residents may not be provided with higher fibre options.