Mealtime caregiving approaches and behavioral symptoms in persons living with dementia: a longitudinal, observational study

Lee, Ji Yeon; Lee, Kyung Hee; McConnell, Eleanor S.

doi:10.1186/s12912-021-00621-3

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…Staff task-centred approaches were not correlated with resident behaviours, inconsistent with previous reports that supported temporal or associative relationships with resident agitation (Gilmore-Bykovskyi et al, 2015;Lee et al, 2021) and aspiration (Gilmore-Bykovskyi & Rogus-Pulia, 2018) during mealtimes, and with resident resistiveness to care during hygienic care (Belzil & Vézina, 2015). The non-significant findings could be related to the dichotomisation of staff task-centred approaches and/ or multivariable analyses that examined associative (vs. temporal) relationships in this study.…”

Section: Staff Task-centred Approachescontrasting

confidence: 99%

“…Comparatively, task‐centred care prioritises activities without adequate consideration of individual needs and preferences and focuses on completion of activities for (rather than with) the individual. Task‐centred care approaches, including providing full assistance for residents with some eating independence, verbal controlling and inappropriate touch, are correlated with disengagement, behavioural challenges and decreased intake (Lee et al, 2021 ; Morrison‐Koechl et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Person‐centred and task‐centred care: Impact on mealtime behaviours in nursing home residents with dementia

Liu

Perkhounkova

Hein

2022

Int J Older People Nursing

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Introduction Mealtime is a critical daily activity to ensure nutrition, hydration, function and socialisation. Interactions between staff and residents during mealtimes are complex and dynamic processes including verbal and/or nonverbal communication that can be positive/neutral or challenging. This study examined characteristics of and relationships between person‐centred and task‐centred care and positive/neutral and challenging mealtime behaviours in persons with dementia. Methods This study was a secondary behavioural analyses of videotaped mealtime observations (n = 110) involving 42 unique staff‐resident dyads (29 staff and 25 residents with dementia) in nine nursing homes. The refined Cue Utilization and Engagement in Dementia mealtime video‐coding scheme was used to code videos during 2019–2020. Dependent variables representing resident mealtime behaviours included positive verbal behaviours, positive/neutral nonverbal behaviours, functional impairments (nonverbal) and resistive behaviours (verbal and nonverbal). Independent variables were staff person‐centred and task‐centred approaches (verbal and nonverbal). Relationships between resident mealtime behaviours and staff approaches were examined using bivariate analysis and logistic regression. Results Staff person‐centred verbal approaches were associated with resident positive verbal behaviours (OR = 1.38, 95% CI = 1.09–1.76), functional impairments (OR = 0.81, 95% CI = 0.66–1.00) and resistive behaviours (OR = 1.65, 95% CI = 1.18–2.31). Staff person‐centred nonverbal approaches were associated with resident functional impairments (OR = 1.33, 95% CI = 1.02–1.74). Staff task‐centred approaches were not associated with resident positive/neutral or challenging mealtime behaviours. Conclusion This study characterised staff approaches and resident behaviours during mealtime care and provided preliminary support on associations between staff person‐centred approaches and resident positive and challenging behaviours. Person‐centred mealtime care practice is recommended by focusing on support of common, challenging behaviours and reinforcement of positive behaviours with adequate consideration of individual needs and preferences.

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Section: Staff Task-centred Approachescontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Person‐centred and task‐centred care: Impact on mealtime behaviours in nursing home residents with dementia

Liu

Perkhounkova

Hein

2022

Int J Older People Nursing

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“…Regarding negative interaction, however, we found that not all care provider-initiated interactions are positive. This also accords with earlier observations, which showed that there are task-centered care provider behaviors that are related to behavioral symptoms (e.g., agitation) or resistiveness to care among persons living with dementia [ 30 , 31 ]. Fortunately, there is room for improvement in the scope of interaction initiated by care providers through educational or institutional efforts.…”

Section: Discussionsupporting

confidence: 91%

Care provider interaction and psychological well-being of persons living with dementia in long-term care: a longitudinal observational study

2023

Self Cite

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Background Although social interaction is important for dementia care and well-being of persons living with dementia, a limited number of studies have reported. This study aimed to examine whether the presence, type, and quality of social interaction is associated with psychological well-being among residents with dementia. Methods This study analyzed 258 videos of 30 participants living with dementia. Social interaction was assessed by quality, type, and presence of interaction. Psychological well-being was measured by positive and negative emotional expressions. A mixed model was used for data analysis since these repeatedly measured observation data were nested within subjects. Results Positive and neutral interactions were significantly associated with positive emotional expressions after controlling covariates, while negative interaction was significantly associated with negative emotional expressions. There was no significant relationship found between interaction presence or type and emotional expressions. Conclusions This study showed interaction quality is essential to promote psychological well-being in persons living with dementia regardless of presence or type of interaction. This study highlights the importance of positive care provider interactions in dementia care. Additionally, institutional efforts to create an environment to reduce negative interactions appears essential to improve the psychological well-being of persons living with dementia. Trial registration The study was reviewed and approved by the Yonsei University Institutional Review Board on October 16, 2020 (ref no: Y-2020-0158).

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“…Prior research showed that staff task-centered care and lack of interaction were associated with resident agitation, and recommended that, when encountering agitation, staff avoid task-centered care (eg, verbal controlling, inappropriate touch) or no response and instead promote person-centered approaches ( 47 ). Although person-centered care has been highly recommended, our study showed that person-centered care may potentially trigger resistive behaviors.…”

Section: Discussionmentioning

confidence: 99%

Temporal Relationships Between Nursing Home Staff Care Approaches and Behaviors of Residents With Dementia During Mealtimes: A Sequential Analysis

Liu

Perkhounkova

Hein

et al. 2023

Innovation in Aging

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Background and Objectives Optimal dyadic interactions are critical to quality mealtime care and outcomes. Prior work supports associative relationships between staff approaches and individual mealtime behaviors, yet evidence on temporal relationships is limited. This study examined temporal associations between staff approaches and resident behaviors during mealtimes. Research Design and Methods Videotaped mealtime observations (N=160) involving 36 staff and 27 residents (53 staff-resident dyads) in 9 nursing homes were analyzed. Sequential analyses using 5-, 10-, and 15-second time windows were conducted for resident positive, neutral, and challenging behaviors as antecedents as well as consequences of staff person-centered and task-centered approaches. Results Residents exhibited positive verbal (35.0%) and positive/neutral nonverbal (12.6%) behaviors, as well as challenging behaviors including functional impairments (27.7%) and resistive behaviors (24.7%). Staff primarily used person-centered approaches (54.1% verbal, 40.3% nonverbal); task-centered approaches were less frequent (5.6%). Immediately (within 5-seconds) after staff person-centered approaches, resident positive/neutral and resistive behaviors were more likely and functional impairments less likely. After staff task-centered approaches, resident positive verbal and resistive behaviors were less likely. After resident positive/neutral behaviors, staff person-centered approaches were more likely. After resident functional impairments, staff person-centered verbal approaches were less likely and task-centered approaches more likely. After resident resistive behaviors, all staff approaches were more likely. The strength of temporal relationships diminished in 10-second and 15-second time windows. Discussion and Implications Staff-resident positive interactions were associated with more subsequent positive interactions. Person-centered care was associated with fewer subsequent resident functional impairments and more subsequent resistive behaviors. Resident resistive behaviors were associated with more subsequent person-centered and task-centered care. Findings confirm the importance of facilitating positive staff-resident interactions and managing functional impairments using person-centered care. Resistive behaviors require additional awareness and attention beyond commonly used person-centered care approaches. Further investigation of temporal relationships is needed using larger diverse samples.

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Mealtime caregiving approaches and behavioral symptoms in persons living with dementia: a longitudinal, observational study

Cited by 8 publications

References 27 publications

Person‐centred and task‐centred care: Impact on mealtime behaviours in nursing home residents with dementia

Person‐centred and task‐centred care: Impact on mealtime behaviours in nursing home residents with dementia

Care provider interaction and psychological well-being of persons living with dementia in long-term care: a longitudinal observational study

Temporal Relationships Between Nursing Home Staff Care Approaches and Behaviors of Residents With Dementia During Mealtimes: A Sequential Analysis

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