Keywords

1 Introduction

Older adults will likely experience decline in one or more abilities as they age, including vision, dexterity, physical function, hearing, and cognition. Aging design is a field that can help the older adult population by providing and designing products/services that meet their specific needs. Yet, Aging design, especially daily life service for older adults’ decline can be a challenging task. Traditional design methods may not be sufficient to develop successful and adoptable concepts. This loss of ability may also be compounded by the emotional impact associated with that decline. It is not uncommon for older adults to also experience social isolation and loneliness or even depression as result of such decline. Older adults’ social activities may help alleviate the feeling, but even individuals living in retirement communities or home have been found to suffer from such conditions. Adequate social interaction can address the aforementioned issues. Results and experience from conducting focus groups and interviews indicates that older adults want to be connected with friends and family by social activities: like outdoor exercise, window shopping, dining gathering in a restaurant will enhance the social connection ability. Therefore, dining is a social activity with deep cultural and emotional underpinnings. Gathering around the table with the families and friends to share a meal enriches older adults’ lives and strengthens personal connections with others. However, it is also a challenging with the rapid pace of today’s society, cultural changes, and new forms of social communication.

The social activity of dining in related public facilities becomes even more important to maintain a sense of well-being development. Because good social connection and communication is fundamental to aging activities. The key factor in considering dining spaces for an older population is the user friendly and barrier free environment and atmosphere. When considering older diners, designers should assume that many have some degree of functional ability loss. Because of variations in age, gender, medical condition, and use of supported devices, achieving the ideal life balance for any given population requires attention to a number of factors. Moreover, with the changing demographics of the world population, it became necessary to examine the factors that lead to a change in dining patterns among the older adults. As the sensory system declines depression, bereavement and the lack of social interaction may lead to life disorders.

Currently in Taiwan, fewer elderly people with functional impairment move to nursing homes, and more choose or have to remain in their own homes. Many of these people are disabled and dependent on others for acquiring, preparing and/or consuming their food. The need for help with preparing food or dining out typically occurs before the need for assistance with meal preparation arises. Some elderly people get help with these activities from different resources. Considering all the negative effects of malnutrition, it seems of utmost importance to identify elderly people living at home at risk of developing malnutrition, or who have already developed it, so that suitable preventive actions and/or treatment can be provided. To do so we need a deeper understanding of the circumstances of older people living at home, with respect to dining requirements, from their perspectives. The aim of the study was to describe home-living elderly people’s views on circumstances that are of importance regarding food and dining, meals and restaurant environment where they go out for a activity.

2 Related Works

2.1 Older Adults and Dinning Preferences

Several studies focused on older adults’ social interaction in a dining space, such as a restaurant, dining room, and others. Abundant studies have also been conducted in the restaurant industry. Hu et al. [1] investigated the perceived service levels of seniors according to the types of restaurant, including quick service, casual dining, and fine dining restaurants in the US. Restaurant services were measured according to (1) food quality, (2) nutrition quality, (3) front-of-house (FOH) service quality, and (4) entertainment quality perceived by users. The findings indicated significant differences in the service levels among three restaurants at a 5% confidence level. For FOH service quality, older adults perceived a higher service level in fine dining restaurants than in quick service and casual dining restaurants. Similarly, nutrition quality in fine dining restaurants was ranked the highest among the three restaurants. With regard to food quality, seniors perceived better food quality in fine dining restaurants than in quick service restaurants. No significant differences were found in terms of entertainment quality. Lee et al. [2] also identified service quality and compared the differences between younger and senior customers. Service quality was measured using the SERVQUAL instrument (i.e., tangibility, reliability, responsiveness, assurance, and empathy). In general, senior customers perceived higher service quality than younger customers, indicating a higher mean score of four out of five dimensions. However, statistical difference was found in one dimension, tangibility, between the two groups at a 1% confidence level. The remaining dimensions remained insignificant. Kim and Jang [3] investigated the psychological aspects, age cognitive decline, and emotional regulation of senior consumers. Specifically, they examined the pre-decision information processing in a casual dining restaurant by comparing young and senior groups. The findings showed that senior consumers tended to choose more familiar restaurants compared with younger consumers. Senior consumers also tended to recover from negative emotions during dining more quickly than younger consumers. Kim and Jang [3] contended that senior consumers are the most promising target in the restaurant industry. Sun and Morrison [4] examined the restaurant patronage behaviors of senior consumers. Two groups (i.e., group 1: frequent and convenience restaurant patrons, group 2: occasional and family restaurant patrons) were segmented according to their frequencies. Five types of restaurants, namely, street food stall, cafeteria, fast food restaurant/café, family restaurant, and fine dining restaurant, were suggested for independent t-test. Group 1 showed stronger patronage behaviors toward street food stall, cafeteria, and fine dining restaurant than group 2 at a 1% significance level, whereas group 2 displayed stronger patronage behavior toward family restaurant than group 1 at a 1% significance level. No difference in terms of fast food restaurant/café was observed. Jang et al. [5] explored the food away-from-home (FAFH) expenditure of US seniors by applying a double-hurdle approach. The study revealed that socio-demographic characteristics and financial resources were the most significant factors of FAFH expenditures. In the casino industry, Wu and Wortman [6] conducted a critical review of studies on senior consumer gaming and uncovered the motivational factors that affect the patronage behavior of senior consumers. The findings suggested that senior consumers are highly motivated by social interaction. Wu and Wortman [6] further asserted that senior consumers were willing to socialize and connect with others.

2.2 Determining the Dining Needs of Older Adults-Using Focus Groups and Surveys

The focus group was an appropriate technique to use for preliminary data gathering in order to obtain an insight into the research topic and the needs of a specific group of people. Researchers have described the benefits of the focus group as a tool for obtaining information about how people think and feel and, consequently, its usefulness in questionnaire design [7, 8]. Practitioners such as Krueger and Morgan [8, 9] have provided guidelines on how to plan for and run successful focus groups, based on their own and other’s experiences. However, special considerations for elderly and disabled elderly participants are lacking in the literature. According to Krueger [8], the focus group is beneficial for identification of major themes and is an effective means of obtaining information from special audiences. Unlike one-to-one interviews and questionnaires, the focus group enables group interaction and greater insight into people’s experiences and opinions. The focus group discussion is particularly effective in providing information about why people think or feel the way that they do [9, 10]. Participants can respond freely and spontaneously, without the limitation imposed by close ended questions [8]. Such participant interaction can rapidly produce valuable ideas rather than the individual responses obtained with questionnaires and one-to-one interviewing [7]. Focus groups can become more than the sum of their participants and can generate ideas that will not emerge from individuals [8]. Conducting such a discussion several times with similar types of participants can identify trends and patterns in perceptions.

3 Research Method

3.1 Method and Participants

Focus group discussions were used in this study because they have a long history in market and social research and had been shown to be very effective in drawing upon respondents’ attitudes, feelings, beliefs, experiences, and reaction in a way that would not have been feasible using other methods [11]. This is especially important when attempting to get in-depth information from older persons, who might be more hesitant to state their opinions regarding dining out in individual interviews. Three focus groups were recruited through flyers placed in older adult community, senior centers and organizations for older persons such as the College of retired persons. In addition to their age (over 65), the inclusion criteria require the participants to have abundant experience of dining out. Specifically, this study seeks to answer the following two research questions:

  1. 1.

    What are the issues that older persons face when dining out in a Chinese restaurant?

  2. 2.

    What are the characteristics of an ageing-friendly dining difficulties and need?

This study combines quantitative and qualitative methods. Qualitatively, focus group discussions were analyzed. Quantitatively, findings from the deeper discussion designed in collaboration with the focus group were statistically analyzed. By combining the analysis of these various methods, the study aims to arrive at a more nuanced understanding of the nature of the dining attitudes and preferences among older people to meet their needs.

3.2 Focus Group Design and Procedures

The study follows the recommendation that the number of people per group should be between 6 and 10 and that the researchers met the same group several times. We also arranged that each session lasted around 2 h in a traditional Chinese restaurant location, which was believed to be helpful for avoiding either negative or positive associations with a particular site or building. The first group decided to use the dining round table. Three sessions topic (before, during and after dining) per group were conducted. The moderators were carefully chosen to involve researchers from design backgrounds. These moderators extracted the information from the expert recruitment and take into four topics for the focus group discussion session. These are: (1) dining preferences, (2) problems, (3) desired features, and (4) concerns. The term ‘problems’ in this study refers to the problems that the participants experienced or perceived when they are dining out in a Chinese restaurant, while the term ‘concerns’ refers to the discomfort that the participants experienced or perceived when other people are dining out in a Chinese restaurant. A list of the sub-topics that need to be covered in the discussions was drawn. The second session was dedicated to brainstorming design features of the ‘closest to ideal’ commercially available for the restaurant environment. To provide context for discussion, the moderators then went to several Chinese restaurants to find a commercial model that most closely matches the criteria stated by the focus groups. The last session aimed at trying the chosen criteria and opinions to verify that the model was indeed acceptable and usable by the focus group participants. The whole sessions were voice-recorded and videotaped using digital recorder for later review and analysis.

The first focus group consists of six older adults (median age 73.5 years) and all are residents from different district in Taipei, three had been dining out 2–3 times a week for several years, and one had less than 1 time. Two dining out very occasionally and therefore chose the accustomed Chinese restaurant with friends and relative. Half of them said that they like to be dining out for several reason, like friend or family reunion The discussions of this focus group had been reported in the following results. The second focus group consists of eight older adults (median age 63.2 years old) and the third focus group consists of seven older adults (median age 67.8 years old) and all are members of Yilan county. They all had frequented times dining out in the past year, all on frequency of once or twice a month. They gather in Chinese restaurant either in fewer person or group. This paper will summarize briefly the merged results from three groups and highlight dining-specific issues raised by the focus groups (Fig. 1).

Fig. 1.
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Focus group discussion

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4 Results and Discussion

Dining is not an automatic process like breathing but is determined by the social environment. When studying dining behavior formulas cannot only be based on the measurement of the amount of food consumed but by other variables such as; food taste, preparation, the psychosocial or environment, and over all lifestyle. Therefore, combining experts’ observations, older adults’ opinions and experiences, the problems older persons might experience when dining in a Chinese restaurant during different stages are:

4.1 Difficulties and Needs Before Dining

The opinions expressed by interviewees from the three focus groups were analyzed, while the audio and video recordings of the interviews were sorted and summarized. As their age increases, elderly people experience physical and psychological changes that add to their difficulties in eating out. The interview data was examined and elucidated as follows (Tables 1 and 2):

Table 1. Difficulties before dining
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Table 2. Needs before dining
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4.2 Difficulties and Needs During Dining

The opinions expressed by interviewees from the three focus groups were analyzed, while the audio and video recordings of the interviews were sorted and summarized. As their age increases, elderly people experience physical and psychological changes that add to their difficulties in eating out. The interview data was examined and elucidated to understand the difficulties and needs during dining for the older adults as follows (Tables 3 and 4):

Table 3. Difficulties during dining
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Table 4. Difficulties during dining
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4.3 Difficulties and Needs After Dining

The opinions expressed by interviewees from the three focus groups were analyzed, while the audio and video recordings of the interviews were sorted and summarized. As their age increases, elderly people experience physical and psychological changes that add to their difficulties in eating out. The interview data was examined and elucidated to understand the difficulties and needs after dining for the older adults as follows (Tables 5 and 6):

Table 5. Difficulties after dining
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Table 6. Needs after dining
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4.4 Discussion and Future Work

Examining the difficulties and needs that older people experience when dining at restaurants requires face-to-face interactions with the elderly and a meticulous observation of their dining behaviors. Through focus group interviews, this study summarized the results into the following findings: Elderly people paid the most attention to perceived attitudes and feelings. The interviews revealed that they placed the most emphasis on attitudes and feelings when dining out; therefore, friendliness and respect were of great significance to them. For them, needs concerning their physical mobility were the most urgent; eating out became increasingly challenging due to the gradual degeneration of their body functions. Their dining experiences were subject to the effects of ageing on cognition, perception, and mobility; hence, to them, rooting out their problems in advance to ease the burden on the elderly will be of the greatest help.

This study had applied a series of structured investigations into how older people present their attitudes and opinion about dining out in a Chinese restaurant. It presents very rich data gathered through a combination of focus group methods. This study is one of the complete studies that use focus group on the issues of ageing and dining, with a certain degree of success. These expert interviews were very informative in deriving topics for focus group discussions and highlighted issues from insight point of view that can act as assistance and hindrance to older adults. Focus group discussions have been proven in this study to be quite successful in gaining an understanding of how older people’s idea to express the difficulties and needs in different stages during dining. Although focus group is less commonly used than other inquiry methods (e.g., interview), the focus group discussions were able to capture basic requirements of dining attitudes preferred by older people, prior to design, and highlighted gender differences in design requirements and preferences. The follow-up survey was intended to gain a balanced view of older users with different characteristics, to provide quantifiable confirmations of the opinions of the focus groups members. Moreover, many of the findings of this survey would represent the patterns of use and opinions of older users at the high end of expertise level. This study can function as a starting point for designers of Chinese restaurant for older persons as well as dining service providers to implement as it provides several very concrete suggestions on design preferences, information on the sources of concerns and annoyance and the patterns of use by older adults; all of which are backed up by reasonably sized data.