How can we foster caring meals? Findings from an ethnographic study in day care centers for older adults in Sápmi, Norway

The study explores how meals in Day Care Centers (DCCs) for older adults can be made nourishing, meaningful, and sensitive to diversity, particularly for Sámi users in Sápmi, Norway. Against a backdrop where social interaction and shared meals are key reasons for DCC attendance, prior work has focused largely on preventing malnutrition through nutrients and calories. The authors adopt a phenomenological, lifeworld-oriented perspective, emphasizing embodied, sensory, sociocultural, and existential dimensions of eating. The research question asks how to foster meals that are adjusted to the bodies cared for—supporting vitality, memory, identity, and well-being through food and mealtime ambience.

Prior research emphasizes nutritional adequacy to counter malnutrition among frail older adults and its costs. More recent work highlights social aspects of eating together, staff influence on mealtime atmosphere, and the need to respect individual and cultural food preferences. Studies among Sámi and other Indigenous and Arctic populations indicate enduring preferences for traditional, local foods (e.g., reindeer, fish, berries) linked to identity and well-being. Phenomenological and lifeworld-oriented care literature frames the body as the locus of experience, where sensing—through tastes, smells, textures, and ambience—supports vitality and meaning. This study builds on these strands to investigate meals as physical, sociocultural, and existential phenomena in DCCs.

Design: Ethnographic, phenomenological study using participant observation and fieldnotes, guided by lifeworld-oriented care principles. Setting and period: Two DCCs for older adults in Sápmi, Norway; seven weeks of fieldwork (autumn 2021–spring 2022). Activities: Joined meal situations (light breakfast, coffee/cake at ~11, early dinner), sometimes assisting with serving and support. Focused on capturing meal “scenes” and embodied communication. Data: Fieldnotes from observations and summaries/keywords from conversations around the table (older adults with each other, with staff, and with the fieldworker). Counts: 48 breakfast/dinner meals observed; 28 coffee-and-cake breaks observed; 19 participants engaged in informative conversations about food. Participants: Older adults (78–93 years), living at home (alone or with spouse), varying cognitive decline (none to moderate) and mobility (independent walking to wheelchair use). Staff included RNs (leaders), auxiliary nurses, social educators, and assistants. Analysis: Interpretive, collective qualitative analysis with reflexive thematic analysis. Coding was collaborative and iterative; themes constructed as interpretive stories of the data. Preliminary coding occurred during fieldwork; later, both authors conducted a three-day coding workshop, developing themes around variability of mealtime experiences and staff shaping of meals. Ethical approvals: Norwegian Center for Research Data (NSD, project 472552) and Sámi collective consent from the Ethical Committee for Sámi Health Research; anonymization procedures followed. Rigor: Triangulation across two sites, multiple data forms (observations and conversations), and two analysts (PhD student and experienced researcher).

- Food made a difference: Familiar, whole foods (e.g., boiled cod with potatoes, carrots, butter; local fresh fish; lamb; reindeer meat) generated liveliness, visible satisfaction, and fuller plate completion. Embodied reactions (smiles, relaxed posture, humming, savoring) and storytelling about childhood practices (fishing, reindeer slaughtering, making goat’s cheese) were common. Some participants reported transient relief from pain while eating familiar dishes. In contrast, reheated, processed meals (e.g., fish puddings, meatballs, salmon burgers) and industrial desserts had little aroma/taste, produced bewilderment or disappointment, required prompting to eat, and led to leftovers. - Ambience—meals as a means to seeing the person: Staff could soften asymmetries and enhance atmosphere through humor and person-centered engagement. Three practice areas emerged: 1) Asking about the person’s past: Noticing embodied changes with familiar foods and inviting reminiscence fostered engagement and pride (e.g., discussing fishing, cheese-making). 2) Respecting individual preferences and offering real choices: Examples included honoring dislikes (e.g., no carrots), seasonal/traditional foods, and varied breakfast options (cheese, cold meats, eggs, herring, homemade jam). In one DCC, breakfast choices were rich; in the other, standardized bread limited choice and created swallowing difficulties for some who preferred porridge. 3) Creating a pleasant environment: Time, pacing, and aesthetics mattered. Unhurried breakfasts sometimes extended to 1.5–2 hours, supporting a calm start to the day. Proper table setting (candles, napkins) and dignified plating were appreciated. Environmental acoustics affected inclusion; an excursion to a cozy, timbered venue improved hearing comfort and stimulated memory sharing. Relevant data points: 48 meals and 28 coffee breaks observed; 19 participants provided informative food-related conversations. Breakfast duration could extend to 1.5–2 hours when unhurried. Participants often declined sugary items (industrial syrup, cakes) and preferred fresh fruit when offered.

Findings address the research question by showing that caring meals are not solely about nutrients but about aligning food and mealtime practices with embodied, sociocultural, and existential needs. Serving familiar, whole foods catalyzed sensory engagement, appetite, memory, and social connection, supporting vitality and well-being consistent with lifeworld-oriented care. Conversely, processed, reheated foods muted sensory cues, impeded recognition and enjoyment, and undermined appetite. Ambience and staff practices were pivotal—using humor, eliciting life stories, respecting preferences, offering real choices, allowing ample time, and creating aesthetic, acoustically comfortable spaces enhanced personhood and dignity at the table. The study underscores that good mealtime experiences are complex, shaped by food quality, cultural fit, interpersonal dynamics, time structures, and environmental design; together, these elements foster nourishing, meaningful, diversity-sensitive meals tailored to the bodies cared for.

Meals in DCCs should be treated as integral to care, nourishing the whole person—physically, socioculturally, and existentially. Fresh, familiar, culturally meaningful foods and person-centered ambiences promote appetite, joy, memory, and social connection. Staff can use meals to see and honor individuals by inviting reminiscence, respecting preferences, providing real choices, pacing unhurriedly, and ensuring dignified settings and supportive acoustics. Policy and practice should move beyond reductionist nutrient frameworks to incorporate sensory, cultural, and existential dimensions. Future directions include intervention projects co-designed with stakeholders to implement and evaluate caring meal practices across diverse cultural backgrounds in DCCs.

Ethnographic constraints limit generalizability (external validity). The researcher’s central role shapes data; however, transparency and triangulation across two DCCs, multiple data sources, and two analysts support internal validity. The fieldwork spanned seven weeks for pragmatic and budgetary reasons; observations were limited to two sites and specific program times. Findings should be interpreted contextually rather than as universal claims.