State of the science: Alleviating mealtime difficulties in nursing home residents with dementia

Preliminary testing using Mokken scaling of an Italian translation of the Edinburgh Feeding Evaluation in Dementia (EdFED-I) scale

“…Crucial to any research in this field is the ability to measure feeding difficulty-i.e. extent and change-and, towards that end, the Edinburgh Feeding Evaluation in Dementia (EdFED) Scale remains the only validated instrument (Aselage, Amella, & Watson, 2011). The EdFED scale has been studied in several forms; the original version had 11 items and the factor structure (Watson, 1996) and the scaling properties (Watson & Deary, 1994) of the EdFED scale in English have been analyzed.…”

Dysphagia, Dementia and Frailty

“…Swallow maneuvers can be utilized to modify different physiologic swallowing deficits, such as utilizing a supraglottic swallow maneuver which employs a voluntary breath hold to facilitate early laryngeal closure and protect the airway during the swallow (26). Postural changes, such as a chin tuck or a head tilt, are used to alter the speed and flow direction of a food or liquid, with the intent of protecting the airway to improve safety of the swallow (27). Unfortunately, compensatory and postural changes may not be appropriate for patients with dementia because they require the patient to utilize these strategies with each swallow.…”

“…Interventions to modify the environments such as reducing distractions, limiting background noise, and creating mealtime routines are also commonly utilized to promote successful eating (27). Specialized feeding techniques such as the Spaced Retrieval Technique (29) or Backward Chaining (30) may enhance the ability of patients with dementia to self-feed and enjoy their meal.…”

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

“…Eating difficulties involve not being able to move food from the plate into the mouth and chew and swallow it and are usually caused by disease processes such as difficulties understanding what a meal is, using a knife, using a fork and/or spoon or forgetting how to swallow once they get the bolus of food in their mouth (Chang & Roberts 2008, Aselage et al . 2011, Jackson et al . 2011).…”