Diversity- and culturally sensitive approaches in nutrition and fluid management in long-term nursing. A scoping review

Abstract Background As a result of decades of migration in Germany, the number of persons with migration backgrounds from different cultures in residential long-term care nursing facilities will increase. As a result, cultural diversity may also have an impact on nutritional aspects in long-term care. The project ‘Digitally supported diversity and culturally sensitive nursing care on nutritional intake’ (NUTRI-SENSE) examines strategies to improve the nutritional and fluid intake of residents with migration backgrounds in long-term care facilities. The interdisciplinary project aims to improve their health and quality of life with a digitally supported nursing process to prevent undernutrition and dehydration. To synthesize the evidence on diversity- and culturally sensitive approaches in nutrition and fluid intake management, a scoping review was conducted. This research led to the question of the extent to which cultural sensitivity with regard to nutrition and fluid intake is addressed in long-term care nursing homes. A literature search of different databases (PubMed, CINAHL, LIVIVO, CareLit ® , manual search: Google Scholar) was conducted in May and June 2025. Results From the 8.010 findings, 28 publications were screened, and 6 publications were included in the review. The evidence on diversity- and culturally sensitive approaches in institutional long-term care nursing regarding nutrition and fluid intake is limited. The main topics are the relationship of culture-specific and dementia-specific needs; the emotional aspects of belonging, food and memories of residents with dementia; meals as a vital source of well-being in nursing homes; the meaning of mealtime experiences in a multicultural society; and, finally, the involvement of family members in the food supply. Conclusion The findings from the scoping review revealed that a systematically developed, diverse and culturally sensitive framework for managing residents’ nutritional and fluid intake in long-term care facilities has not yet been established. Such a framework is the goal for subsequent research and the development of interventions within the NUTRI-SENSE project. In the context of international population ageing and increasing needs in the long-term care sector, the development and evaluation of culturally and diversity-sensitive nutPrition and hydration strategies are of broad, cross-national relevance.