Eating performance in relation to intake of solid and liquid food in nursing home residents with dementia: A secondary behavioral analysis of mealtime videos.
Wen Liu, Kristine Williams, Melissa Batchelor-Murphy and 2 others
PMID 30660444WHAT IT FOUND
In nursing home mealtimes for people with dementia, eating attempts residents completed themselves and attempts that lasted longer were more likely to result in food or drink being taken than staff-fed attempts.
Key findings
01In 99 video clips, longer eating attempts were associated with higher odds of intake. The odds increased by a factor of 2.73 for resident-completed cycles and 17.80 for staff-facilitated cycles.
02For both liquid and solid food cycles, resident-completed cycles had greater odds of intake than staff-facilitated cycles, with odds ratios of 3.60 for liquid and 10.69 for solid food.
03As cycle duration increased, odds of intake rose by a factor of 15.42 for liquid cycles and 3.15 for solid cycles.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis of archived videos, not a trial of mealtime assistance, so it cannot show that changing staff technique will improve intake. The videos were clips of mealtime scenarios with varied durations, not whole mealtimes, so patterns from the beginning to the end of a meal were not described. Only one-on-one staff-resident interactions were analysed, so the findings may not apply when more staff or residents are present. The sample was a convenience sample from the parent study, and the analysis used 99 clips involving 23 residents, which limits generalizability. Resident eating ability was not controlled for in the analysis, even though it may influence whether a cycle is resident-completed or staff-facilitated. Food texture and liquid thickness were not collected, so the study did not examine thin versus thickened liquids or texture-modified foods. Missing data were not imputed, and some cycles were excluded because of missing resident age or functional status.
Declared interests
No conflicts of interest were declared.
The easy way to misread this
Do not conclude that staff should feed residents less or that resident self-feeding will improve nutrition. The study observed individual eating cycles during usual care, did not test a mealtime intervention, and did not analyse whole-meal intake.