Background: Dysphagia affects an estimated 58,000 to 174,000 older adults—approximately one in seven individuals aged 65 and above. This condition poses significant physical, psychological, and social challenges that can compromise the quality of life in Singapore, which is projected to become a super-aged society this year. In nursing homes, mealtimes contribute significantly to nutritional intake, physical functioning, emotional comfort, and social connection. Hence, improving mealtime care is crucial to supporting older adults’ nutrition, dignity, and overall well-being.
Objectives: This study explores nursing home staff perspectives on how molded soft meals influence older adults’ meal experiences, focusing specifically on comfort, dignity, autonomy, and social connection. By examining these staff insights, this study aims to understand how care providers interpret and support these vital aspects of older adults’ well-being during mealtimes.
Methods: A qualitative, phenomenological approach was used, employing semi-structured interviews and thematic analysis. In-depth, semi-structured interviews were conducted with 13 staff members from a single nursing home, including 8 care staff (2 senior nursing aides, 3 nursing aides, and 3 healthcare assistants), 4 support staff (1 senior staff nurse, 1 staff nurse, and 2 enrolled nurses), and 1 management staff member (a nurse manager). The findings are limited by the reliance on staff-reported data, as direct interviews with older adults and objective mealtime observations were not conducted.
Results: Staff identified three key factors shaping meal experiences: (1) the significance of food presentation, (2) communal dining dynamics, and (3) the physical environment. According to staff reports, molded IDDSI Level 4 (pureed) diets supported the dignity of older adults and improved intake by easing chewing and swallowing while retaining a familiar food appearance. Staff also observed that positive social interactions, such as family-style dining and a homelike atmosphere, enhanced older adults’ moods and appetites. Furthermore, staff perceived that welcoming, flexible dining spaces actively promoted independence, reduced anxiety, and encouraged conversation among the older adults.
Conclusion: Staff perspectives suggest that the integration of thoughtful food design, social dining practices, and a supportive environment can collectively enhance older adults’ meal experiences by addressing both their physical and psychosocial needs. These insights offer practical, frontline-identified strategies to optimize care. Future research should expand to multiple nursing homes to include firsthand perspectives from older adults themselves and to evaluate the longitudinal effectiveness of these diverse dining approaches.

Dysphagia, Texture-modified diet, Dining styles, Environment, Meal experience, Dignity, Autonomy, Social interaction