Cultural and Ethnic Dimensions of Mealtime Practices in Long-Term and Residential Care: a Comprehensive Scoping Review.

Background: As ethnically diverse populations increasingly access long-term care (LTC) and residential care facilities (RCF), mealtimes emerge as vital opportunities to preserve cultural identity, foster social connections, and support well-being. However, systemic barriers and institutional limitations often prevent culturally inclusive mealtimes, marginalizing minority populations and perpetuating inequities in mealtime delivery. This review explores the state of knowledge on cultural and ethnically diverse mealtime practices and menu options within LTC and RCF. Methods: Using the Joanna Briggs Institute framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) guidelines, a comprehensive scoping review was conducted. Databases and grey literature sources were systematically screened, with data extracted and analyzed using a hybrid thematic analysis. Findings were organized by the socioecological model, exploring influences at intrapersonal, interpersonal, community, institutional, and societal levels. Results: A total of 126 full-text manuscripts were reviewed and 42 were included in the final analysis. Key themes emphasized food's role in cultural identity, and highlighted best practices in ethnic-specific facilities, which tailored menus and rituals to residents' needs. Barriers included budget constraints, limited access to culturally specific ingredients, insufficient staff training, and standardized menus. Families often bridged these gaps, straining their resources. Promising practices included flexible meal schedules, resident-centred menu planning, staff training, and partnerships with cultural organizations. Recommendations focused on increasing funding, implementing flexible policies, and studying the long-term impacts of inclusive practices. Conclusions: Culturally inclusive mealtime practices have the potential to transform LTC and RCF by promoting dignity, enhancing quality of life, and addressing systemic inequities. Ethnic-specific facilities provide effective models, but broader adoption of best practices is necessary for mainstream care settings.