A qualitative study of professional caregivers' perceptions of processes contributing to mealtime agitation in persons with dementia in nursing home wards and strategies to attain calmness

Abstract

AimDescribe professional caregivers' perceptions of factors and processes contributing to mealtime agitation and strategies for attaining and maintaining calm mealtimes.DesignQualitative and descriptive.MethodsA convenience sample of professional caregivers working in two wards for residents with dementia was used. Data were collected during two focus‐group interviews and supplemented with field notes from six reflection groups. Thematic content analysis was conducted. Data collection occurred from 2010–2011.ResultsProfessional caregivers perceived agitation during mealtime as resulting from negative feelings in residents triggered by a lack of or negative social interaction, too much or ambiguous stimuli or demands exceeding residents' capacity. Strategies for attaining calm mealtimes involved thorough planning beforehand. During mealtime, professional caregivers focused on establishing a positive community around the table, helping residents focus on eating and continuously observing residents for subtle signals indicating that agitation was about to develop. The prerequisites to succeed with the strategies were knowledge of the residents' preferences and abilities, knowledge sharing within the team and awareness of one's own communication style. Thus, the professional caregivers operationalized person‐centred care in a mealtime context.

<p>Understanding Interactions Between Caregivers and Care Recipients in Person-Centered Dementia Care: A Rapid Review</p>

“… 36 When interacting with care recipients, caregivers need to respect them 30 , 33 , 35 , 36 , 41 and build a calming, peaceful, positive environment. 29 , 35 , 38 …”

“…To provide person-centered dementia care, caregivers need to have a good knowledge of care recipients. 38 This knowledge includes mental and physical health, cultural background, value, biography, personality and preferences and needs. 11 , 28 , 37 , 38 , 40 , 42 In addition to health records, this knowledge may also be obtained through reminiscing with care recipients, 43 knowledge sharing from other caregivers 38 and communication with relatives.…”

“… 38 This knowledge includes mental and physical health, cultural background, value, biography, personality and preferences and needs. 11 , 28 , 37 , 38 , 40 , 42 In addition to health records, this knowledge may also be obtained through reminiscing with care recipients, 43 knowledge sharing from other caregivers 38 and communication with relatives. 29 , 44 , 45 Reminiscing with care recipients can help caregivers to understand who the person is, what matters to them and why they have certain behaviors.…”

“…The process of providing dementia care consists of multiple interactions between caregivers and care recipients. 30 , 38 , 44 In the process of interaction, caregivers should respect care recipients, 28 , 30 , 31 , 37 have a positive attitude 33 , 37 and build a calming, peaceful, positive environment. 35 , 38 …”

“… 33 Good interaction also leads to psychological well-being, 32 , 33 helping care recipients to stay calm and peaceful. 38 This consequently results in cooperation from care recipients in smooth care delivery and improved physical well-being. 27 , 28 …”