Understanding the role and meaning of food for older people through participant-driven photo-elicitation.

Abstract

Background: Food is a universally shared need regardless of age, gender, or heritage. It is an everyday occupation and there is value in exploring aspects of daily life that may seem mundane or ‘hidden’. Uncovering the unnoticed is something that has been of interest to many different fields of study including occupational science which is drawn upon in this research. Occupation, here, meaning the things people want and need to do to lead fulfilling lives of meaning and purpose. Food occupations can be any activities connected to food, from purchasing or growing to cooking and eating. The global population is ageing, people are living longer, and financial stability, physical ability and social connections are identified by older people as important for positive active ageing. Food is an occupation that can be connected to any or all of these areas. Research into older people’s experiences of food has often focused on nutritional needs, life course events or age-related health changes impacting on food occupations. There is more limited research about independent, active, older people and what role food plays in their day to day lives and what meaning it holds for them. Aim: The aim of this research was to develop an understanding of the role and meaning of food for older people living independently in their own homes. Participant-driven photo-elicitation was used to provide new insights into this less investigated topic. Methods and methodology: This is a qualitative study founded in hermeneutic phenomenology. People’s experiences of their food occupations are individual, and these experiences can be interpreted in different ways with knowledge constructed from this process. Ten participants (six male, four female) aged 67 – 86 years old were given digital cameras and asked to take photographs of their food and any associated items and activities. The images were used to carry out unstructured interviews. Participants led the process, deciding what photographs to take and which images to discuss. Principles of Interpretive Phenomenological Analysis as thematic analysis were then used to uncover individual and shared themes. Findings: Three main themes emerged: Identity, Belonging and Environments. Findings highlighted the individuality of each person’s interaction with food. Identities being reflected in people’s choice of foods and roles within the home. Findings from previous studies were echoed but also new perspectives emerged. Previous research has predominantly viewed older people’s food roles through gendered discourse identifying women as the main provider with men having minimal involvement. In this research shared roles between older couples were discussed with a less binary male and female divide. A sense of belonging and social connection was generated through past and present food experiences reflecting the temporal aspects of belonging. Consideration of environments enabled exploration of how the natural world may influence people’s food occupations as well as food providing an opportunity to connect with the outdoors. Conclusions and implications: This research has demonstrated that the role and meaning of food for older people can be complex and very individual. Some older people may not be particularly interested in food however others may want to continue to manage all aspects of their food occupations. This could include making discerning judgements about the quality of items, going to different shops for different foods, eating in different places and making active, intentioned decisions about what to eat. To achieve this, the accessibility of the built and natural environment is important to minimise physical and societal barriers to an active, autonomous life in relation to food. It is also essential for people to understand the importance of food at an individual level. Taking the time to really know what food means to someone can show that their food values have been heard, respected, and responded to. Understanding the role and meaning that food holds for older people is essential to ensure active engaged lives are maintained.