The meanings of eating, cooking & shopping for older women who are

cooking less: the CAFÉ study

Drs Lee Hooper & Kathleen LaneUniversity of East Anglia

Question

• What are the meanings of food for older women, and how do they change when women reduce their involvement with food?

Methodology

• Recruitment of 40 women aged 65+ living at home and not cooking their main meal from scratch on at least 4 days/week

• 20 women had 2 individual interviews (~6 months apart)

• 20 women were involved in a single focus group interview

• Audiotaped, transcribed in full, pseudonym chosen by participant

• Iterative analysis, modified grounded theory

The participantsCharacteristic Whole group (n=40)

Mean age (sd) 82.2 (6.3)

Home owner Council/housing assoc’n

13 (32.5%)19 (47.5)

Live in Index of Multiple Deprivation most deprived quintile

14 (35%)

Urban 31 (77.5%)

Living alone 34 (85%)

Own car or car access Limited access Public tpt only or very limited tpt

7 (17.5%)18 (45%)

15 (37.5%)

Lives in sheltered accom. 18 (45%)

Attends day centre/ lunch club 20 (50%)

Meals on Wheels 5 (12.5%)

Regular use of ready meals 17 (42.5%)

Rely on others for main shop 17 (42.5%)

Meanings of eating, cooking & shopping

• Think back for a moment to a recent meal (within the past couple of years) that you really enjoyed – what about that meal was particularly pleasant?

• Now think of a less pleasant recent meal – what about it was less pleasant?

Meanings – Social food

“My grandchildren they like my cooking which is rather nice”. Bananas (69g)

“I miss very much not feeding my family. …You still want to feel that you’re needed to produce a meal. …It’s because you no longer are needed to do that job … I hate it … today I would have preferred to have cooked, done a proper lunch. To me to produce a few sandwiches on a plate with a bit of lettuce round isn’t like giving my great-grandchildren a treat, but that’s what they want.” Kathleen (90g)

“I love cooking a meal when it’s for several people. I don’t think I’d put that amount of time into cooking a meal just for me.” Deena (84i)

Role of cooking for (looking

after, loving) others

Meanings – Social food

Honey (70i), discussing eating at a day centre:“sometimes we don’t say a word while we’re eating….it’s a calm feeling, you know that you’re there with someone and then when you’ve finished your dinner and you’re waiting for your sweet to come, you sit there chatting and that and I don’t know, it’s so easy. So lovely and easy”

Sharing eating

May (83g) reflected a common dislike of eating alone: “I cook and then I think to myself, oh I don’t want to sit there and eat that all on my own!”

Meanings – Social food

“I am anti-food at friends… Food shouldn’t be social.”….“I can eat [at the lunch club], but I eat very, very quickly…. always finish long before anyone else and sometimes I try and think well if I …have a couple of glasses of water as well to try and make it last.” Matilda (79i)

Importance of food in

socialising

“I’ve now started having an open day at my house for my friends … I don’t like cooking, I don’t like catering, but I can make a cup of tea and I can put a biscuit on”.

Bubbles (65g)

“…as a matter of habit, I might find myself wanting to say, ‘Oh yes, well I’ll have a group for such and such a meal,’ but hopefully before I actually say it, I realise that no, I would like them to be there, but I don’t want to feed them and so that’s that… [sighs] so be it” Henrietta (83i)

Meanings of food and food-related activity

• Social food– Role of cooking for (looking after, loving) others– Sharing eating– Importance of food in socialising

• As contact with food is reduced these meanings remain– Women retain the role of cooking for others

where they can, miss it where it is lost– They actively search out opportunities to eat

with others (eating alone is VERY alone)– Are creative about ways to include food & drink

provision to create social events

Meanings - pleasure“having good food, I think, is most important. Especially when you can’t have many other pleasures in life”. Helen (84i)

“if you’re feeling a bit low, it’s surprising what ….a good fried breakfast will do for you”, Kathleen (90g)

“when I come in I need to cheer myself up… I’ve noticed it time and time again. I’ve said goodbye to friends, or something like that, I think I’ll have a piece of chocolate” Sally (85i)

Meanings - pleasure“I don’t care what I eat, as long as I eat it. …I just eat to live.” Sally (85i)

“Food never did interest me much.” Tish (81i)

“[That I can’t prepare meals from scratch] doesn’t bother me unduly. What I get is good food and it’s suitable food and it’s edible and it’s quite pleasant in most cases. I don’t really worry about it… You have to accept the realities of the situation. The reality is I can’t do it any more, so you have to do without it.” Helen (84i)

Meanings of food and food-related activity

• Pleasure– Provide pleasure and comfort for many– Reflect emotions

• As contact with food is reduced these meanings remain– For many women food can provide pleasure

when fewer other pleasures remain– This may make it particularly hard for women

who lose interest in food or who are not able to obtain pleasure through non-ideal food provision

Meanings – being organised & in charge

“I can’t go shopping and see all what’s going on… I like to have a choice, I’d like to go around a supermarket and have a look and see what I want…I haven’t got no bananas this week… [The carer who shops] forgot them. … I would remember if I went round there” Tizzie (76i)

“I’d got a whole [loaf] in the fridge, but I bought another one… I tend to try and keep them in, rather than not be able to find anyone to get me one.” Deena (84i)

Shopping important to

self-organisation

Meanings – being organised & in charge

Demonstrating skills & problem

solving

Bubbles (65). [quoting comment to her daughter] “if I get in a situation where I’ve got to do a big meal, you’ll have to help me.” …. So I did have help, but that does panic me now if I’ve got a lot to cook for….Bananas (69). You’re so used to cooking for one or two.Bubbles. Yeah, you forget how you used to do it.Harriet (78)…I’ve had my family round, but I just feel I can’t do what I used to.”

Meanings – being organised & in charge

“there weren’t any small quantities … I said [to an elderly shopper], ‘Are you having difficulty with size?’ He said, ‘yes… I don’t want all that lot’ ‘Nor do I, let’s share it!’ So we [shared out a single pre-packed bag of potatoes], went on our merry ways… the assistant manager bustled up to me, ‘Have you just bought some potatoes with a gentleman?... You can’t do that.’ So I said, ‘There is another way round this. … You start packing in smaller bags. Neither of us wanted a large quantity” Deena (84i)

Demonstrating skills & problem

solving

Meanings – being organised & in charge

“I will make myself go down there once a day. I will deliberately leave something behind, the cat food or my milk, I will deliberately leave something that I know I’ve got to go back for the next day!… I make myself do it.” May (83g)

Necessity for self mastery

“they boast about it, ‘now larger size’. Well I have to half it…. to half it when it’s frozen is difficult, so I cook the whole thing and I don’t like cooking, re-cooking these things, so I –– I eat it cold. It’s vile, absolutely vile….I make myself do that…. I don’t like throwing food away” Sally (85i)

Meanings – being organised & in charge

“our cooking, as we get older, is conditioned by our health. Certain things…we just daren’t eat…. I feel now that I’m a nuisance when I go out for a meal.... you don’t like to say to people, “I don’t want this!” ....So I do find I prefer now to provide for myself, rather than go out” Blacksmith (82g)

Maintaining health & wellbeing

Meanings of food and food-related activity

• Being organised and in charge– Shopping important to self-organisation– Demonstration of skills and competence– Problem solving – Self-mastery– Avoiding waste and being economical– Maintaining health and wellbeing

• As contact with food reduces, meanings remain– Loss of shopping ability and cooking skills makes

women anxious - they work hard to remain organised

– Remaining organised and in charge requires constant problem solving and compromises

Meanings of food and food-related activity

• Overall, as contact with food reduces, meanings remain

• However, to retain these meanings women problem solve, be versatile, tackle obstacles & work hard

• Women find it difficult when they do lose aspects of their lives that underpin these meanings (ability to shop or to cook for others) and it does seem to impact on their sense of self esteem

Thank you • Fiona Poland, Senior Lecturer Therapy Research, School of Allied

Health Professions, UEA• Nigel Lambert, Head of Risk and Consumer Sciences, Institute for

Food Research, Norwich• Hilary MacDonald, Social Policy and Research Manager, Age

Concern Norfolk• Sheila Fleming, Experienced Consumer Advisor, PPIRes• Carol Vince, Experienced Consumer Advisor, PPIRes• Mandy Wellings, Experienced Consumer Advisor, PPIRes• Monique Raats, Primary Investigator of Food In Later Life Study,

Co-Director: Food, Consumer Behaviour and Health Research Centre, University of Surrey

• Paula Skidmore, Nutritionist, School of Medicine, Health Policy and Practice, UEA

• John Potter, Professor of Medicine for the Elderly, UEA