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Experimental Comparison of Efficacy for Three Handfeeding Techniques in Dementia
Author(s) -
BatchelorMurphy Melissa K.,
McConnell Eleanor S.,
Amella Elaine J.,
Anderson Ruth A.,
Bales Connie W.,
Silva Susan,
Barnes Angel,
Beck Cornelia,
ColonEmeric Cathleen S.
Publication year - 2017
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14728
Subject(s) - medicine , meal , dementia , nursing homes , malnutrition , randomization , gerontology , latin square , nursing , clinical trial , food science , disease , rumen , chemistry , fermentation
Background Nursing home ( NH ) residents who require assistance during mealtimes are at risk for malnutrition. Supportive handfeeding is recommended, yet there is limited evidence supporting use of a specific handfeeding technique to increase meal intake. Objectives To compare efficacy of three handfeeding techniques for assisting NH residents with dementia with meals: Direct Hand ( DH ), Over Hand ( OH ), and Under Hand ( UH ). Design A prospective pilot study using a within‐subjects experimental Latin square design with randomization to one of three handfeeding technique sequences. Setting and Participants 30 residents living with advanced dementia in 11 U.S. NH s. Measurements Time required for assistance; meal intake (% eaten); and feeding behaviors, measured by the Edinburgh Feeding Evaluation in Dementia (EdFED) scale. Intervention Research Assistants provided feeding assistance for 18 video‐recorded meals per resident (N = 540 meals). Residents were assisted with one designated technique for 6 consecutive meals, changing technique every 2 days. Results Mean time spent providing meal assistance did not differ significantly between techniques. Mean meal intake was greater for DH (67 ± 15.2%) and UH (65 ± 15.0%) with both significantly greater than OH (60 ± 15.1%). Feeding behaviors were more frequent with OH (8.3 ± 1.8%), relative to DH (8.0 ± 1.8) and UH (7.7 ± 1.8). Conclusion All three techniques are time neutral. UH and DH are viable options to increase meal intake among NH residents with advanced dementia and reduce feeding behaviors relative to OH feeding.