The aim of this service evaluation was to understand the factors affecting meal provision on a dementia ward and assess whether meals-based dietary intake met estimated mean energy requirement and reference nutrient intake (RNI). A mixed-methods approach was adopted: 1. Mapping the dietary intake for a cohort (n=6) of inpatients with advanced dementia over a period of four consecutive days. 2. Semi-structured interviews to explore the experiences of the professionals (n=5) involved.

Two of the participants’ four-day mean intakes did not meet their estimated energy requirement based on meal provision. All participants apart from one met the target of 0.75g of protein per kg body weight per day for the general population. Several of the nutrients consumed were at or exceeded the RNI for adults of this age, although participants’ mean dietary vitamin D intake was substantially below the RNI for the general population. The themes included communication, time pressure and the continuity of service provision.

The meals provided were nutritionally sound. Individuals’ nutritional status was improved through staff supporting them with eating. The contribution of drinks and snacks to nutrient intake warrants further exploration. Effective communication between food providers and ward areas is important. Mealtimes should reflect patient need – for example, having the main meal in the evening and a lighter option at lunch. This does not clash with the benefits of a flexible breakfast time.