Date of Award

Summer 2019

Project Type


Program or Major

Natural Resources and Environmental Studies

Degree Name

Doctor of Philosophy

First Advisor

John Carroll

Second Advisor

Semra Aytur

Third Advisor

Thomas Connelly, Jr.


The purpose of this study is to understand how innovative practices affect the satisfaction elder-care facility residents have with their food-related life. The study looks through the lenses of food and food service activities, related medical care activities, and facility design.

The Older Americans Act of 1965 defined the basic rights of elders in American society. The statement and objectives codified in that Act have provided the outline for eldercare in the community and in residential care facilities ever since. Legislative updates in 2017 more clearly identified “person-centered” care as the ideal in elderly care homes. Research using the diffusion of innovation theory was pursued in two nursing homes which participated in a naturalistic inquiry. Different innovative practices regarding the food-related life of each resident was the focus. Self-efficacy theory was used to better understand the perspective of the residents and their reactions and responses to the care they receive. Ethnographic research using observations, interviews and historical and current literature over an eight-month period examined the day-to-day lives of elders in these care homes, concentrating on elements related to the food and food systems.

Results show that co-occurring innovations obscure the influence of single culture change components and also support components in ways that are not yet clearly understood. Nursing and food services staff training is lagging behind the person-centered culture change innovations related to food and food services activities.