Improving food provision in a Guyanese home for the elderly: a participatory approach.

OBJECTIVES To conduct a needs assessment of all aspects of food provision in a residential home and to evaluate a subsequent nutrition intervention. DESIGN An intervention study using a before and after design. A participatory approach was adopted and quantitative and qualitative methods used throughout. The intervention involved a revised menu, kitchen equipment, and establishing wholesale shopping and food donations. SETTING A residential home for senior citizens in Guyana. RESULTS Meals at the home were nutritionally inadequate and deeply unpopular with the residents. Intakes of fruits and vegetables were low and the home was heavily reliant on donated soya mince and rice. Meals were served within an eight-hour period to accommodate the staff's hours of work. Cutbacks in the food budget indicated that the financial state of the home explained some of the problems. The intervention was unable to address all problems identified, but led to substantial improvements in the nutritional adequacy of the food provided following the inclusion in the menu of a number of nutrient-dense foods such as chicken liver. The new menu was acceptable to the cooks and largely popular with the residents, although some problems persisted. CONCLUSIONS The results show that improvements in the nutrient profile of the diet could be achieved with a flexible, community-based, participatory approach that addressed all elements of a home's food provision system. The changes also proved largely popular with the residents, thus potentially contributing to their quality of life.