Special Section—Behavioral symptoms of dementia: their measurement and intervention. Keeping wandering nursing home residents at the table: improving food intake using a behavioral communication intervention

Abstract

The purpose of this multiple case design study (n = 3) with an embedded experiment was to determine the effect of the systematic use of a behavioral nursing intervention on the mealtime behavior of nursing home residents with probable Alzheimer's disease. It was hypothesized that the systematic behavioral intervention would increase time spent seated during the meal and proportion of food consumed while decreasing the frequency of table-leaving events during mealtime. The intervention was designed to impact the proximal factors of physiological need and social interaction from the Need-Driven Behavior Model. Results demonstrate that all cases were able to sit at the table longer and eat more food during the intervention, while body weight for all cases remained stable throughout the study. Two of the three cases left the table fewer times during the intervention. There were no statistically significant changes in proportion of fluids consumed in any case.

Mealtimes in Nursing Homes: Striving for Person-Centered Care

“…The relationship was only partially explained by meal duration. Regular social interactions, by frequently making comments about the food and the mealtime experience, along with non-verbal cuing, may also help residents who tend to wander from the table to sit longer and have better intakes (49). Based on participant observation in retirement homes, a range of social interactions among tablemates were identified.…”

ESPEN guidelines on nutrition in dementia

“…Positive effects were reported when patients with severe dementia were fed by the same carer compared to various carers [124]. Specific behavioral and communication strategies have been shown to positively affect eating behavior and increase food intake in three case reports [125] and in a small controlled, non-randomized study [126].…”

Wandering and the Physical Environment

“…Several intervention studies have focused on the bathroom and dining room, manipulating the individual social and/or physical environment to decrease behavioral symptoms and improve the bath or meal experience, all with promising results 20,[25][26][27][28] ; however, only 1 study was focused on wandering. 25 Several studies have examined the impact of light on agitation, a behavior closely associated with wandering. Individualized white noise used in 2 studies 29,30 produced mixed results in decreasing agitation.…”