Healthy ageing through a “dignified meal” – medical students learning holistic care for dysphagic older patients… in a kitchen

Abstract

“Let thy food be thy medicine and medicine be thy food.” – Hippocrates (400 BC) Besides nutrition, the lived ‘dining experience’ is also instrumental to older patients’ psychological wellbeing. In Hong Kong, the prevalence of dysphagia in older adults has been shown to be as high as 57.1% in aged care facilities. Dysphagia can be a result of stroke, dementia, head and neck cancer, or the normal ageing process. Swallowing difficulties present additional challenges to patient care such as malnutrition, dehydration, aspiration pneumonia, unpleasant mealtime experience. It is essential for medical students to learn about nutritional and unmet psychological needs of this patient group. Culinary medicine is a trending field of medicine that combines sciences and culinary arts to create food that promote that is delicious, appealing, and promotes wellness. In recent years, scholars believe that structured cooking sessions could triumph over traditional lecture for teaching nutrition and dietetics in medical schools. A U.S. study involving 627 medical students reported that a hands-on cooking and nutrition elective at a teaching kitchen outperformed traditional clinical education in improving student attitudes and competencies in counselling patients on nutrition. The objective of this project is for medical students to better understand the challenges to healthy ageing brought by swallowing difficulties, to gain insight into texture-modified meals as a potential remedy, and to reflect upon the myriad modalities of holistic care from a patient perspective, all through a hands-on care food preparation workshop designed and developed by a social enterprise. As part of a Medical Humanities Programme at HKU, 20 Year 2 MBBS students attended a workshop designed and led by an award-winning social enterprise The Project Futurus. The workshop comprised (i) introduction to Japanese Engay (easy-to-swallow) Food and its underlying person-centered care principles, followed by (ii) a hands-on experience using food gelling agents and moulds in creating their own softmeal dishes. Student feedback was collected afterwards. Despite its small scale, this community partnership introduces the first-ever culinary medicine workshop for medical students in Hong Kong. Student feedback was overwhelmingly positive and there is great potential internalizing the activity within HKU’s MBBS curriculum. It is hoped that hands-on approach could also promote medical students’ knowledge of nutritional needs of dysphagic older patients, and to raise student’s interest in holistic care for patients suffering from swallowing difficulties. This initiative is supported by Gallant Ho Experiential Learning Fund at The University of Hong Kong.