Zih-Ling Wang is a PhD in Nursing Science candidate and one of the center’s 2025-2026 Healthy Aging Scholars. Her scholarship project is on “Beyond the Plate: A Multi-Methods Investigation of Mealtime Experiences and Modeling Independence in Eating in Dementia Care.” Her faculty mentor is Basia Belza.
What made you interested in nursing research?
In my fourth year of college, we had a class about research. I realized there was another way you could go in the nursing field, besides working in a clinical setting. After graduating, I did a clinical job for some years, then I went to be a dementia case manager to learn more about long-term care. There, I realized that there was a gap between policy and families’ needs.
That’s why I decided to pursue my master’s degree, to better understand health policy and law. During my master’s program, I realized that research gave me a way to address the questions I kept seeing in practice.
Do you have an example of where you saw a need that was different than the policy?
For example, for people with young onset dementia, some of them refuse to go into the daycare senior center because they feel like they are different than the older people. Also, they often still have the capability to work, but the employment environment in Taiwan doesn’t allow them to continue working.
Could you briefly talk about the project you’re doing with the de Tornyay Center scholarship?
My dissertation is about understanding people with dementia’s eating experiences and their level of independence in eating during mealtimes in long-term care communities. I’m trying to understand how environmental factors, personal factors, or other related factors will influence their eating experiences and performance.
What made you want to study this particular topic?
I think people sometimes focus on what people with dementia can no longer do, but many still have abilities that can be supported and maintained. Eating is not only about nutrition, it is also connected to dignity, autonomy, and social interaction. I wanted to better understand how we can help people maintain their independence for as long as possible. So that’s why I brought this topic to UW to continue working on. I want to understand more about what the eating experience is, what the eating environment is, and what those things mean to this population.
What do you hope the impact of your research might be?
I hope that this research will be a foundation. I also hope this research helps caregivers, staff, and long-term care communities better understand the factors that influence eating independence for people with dementia. In the long term, I hope the findings can help guide interventions, environmental changes, or care strategies that support people in maintaining their abilities and enjoying a better mealtime experience.
Are there any other common eating challenges that you see with the people that you’re working with?
Most of the challenge is when people with dementia are getting worse, they need more cues to help them eat. That depends on the person’s ability stage.
For some staff, the challenge is recognizing a sign that people with dementia need help to eat. In the long-term care community, there are so many residents, you don’t have time to oversee everyone.
You mentioned people with dementia need more cues to eat. What kind of cues?
Some people with dementia doze off during mealtime and you need to wake them up. Or you need to put the spoon into their hand. If they have a family caregiver along with them during mealtime, the family caregiver will use cues like open your mouth, you need to chew, you need to swallow, and now you need to sip water. You need to break down step by step everything we think is easy for us, like chewing and swallowing.
And if they don’t want to eat, they just rest their hand on the spoon to stop it. If you keep trying, they won’t eat. That is another challenge when you’re using the cues, you need to observe the person with dementia and their facial expression to know if they are full or not.
Has there been anything that surprised you while working on the project?
Right now, I am also doing an observation study in different communities. I realized that the communities have two different groups: one is a more Asian group, one is a more western group, and I feel like what they need during the mealtime is also affected by the cultural context.
With a resident in the Asian community, we talked about what eating means to her, and she said that eating is just eating. It doesn’t mean anything, I come downstairs to eat everyday and it’s just my routine.
Another resident I met from the western community talked what eating means to her, and she said that she liked to eat as a family group. Every day she saw that she had her mealtime with the same people at the same time. She felt it was like family there.
That experience reminded me that mealtimes are not only about food. They can have very different meanings depending on a person’s culture, life experiences, and social relationships.