was subsequently identified in the Key points section. This notice is included in the online and print versions to indicate that both have been corrected [26 January 2010].Objectives: To construct a training protocol for spaced retrieval (SR) and to investigate the effectiveness of SR and Montessori-based activities in decreasing eating difficulty in older residents with dementia. Methods: A single evaluator, blind, and randomized control trial was used. Eighty-five residents with dementia were chosen from three special care units for residents with dementia in long-term care facilities in Taiwan. To avoid any confounding of subjects, the three institutions were randomized into three groups: spaced retrieval, Montessori-based activities, and a control group. The invention consisted of three 30-40 min sessions per week, for 8 weeks.Results: After receiving the intervention, the Edinburgh Feeding Evaluation in Dementia (EdFED) scores and assisted feeding scores for the SR and Montessori-based activity groups were significantly lower than that of the control group. However, the frequencies of physical assistance and verbal assistance for the Montessori-based activity group after intervention were significantly higher than that of the control group, which suggests that residents who received Montessori-based activity need more physical and verbal assistance during mealtimes. In terms of the effects of nutritional status after intervention, MiniNutritional Assessment (MNA) in the SR group was significantly higher than that of the control group. Conclusion: This study confirms the efficacy of SR and Montessori-based activities for eating difficulty and eating ability. A longitudinal study to follow the long-term effects of SR and Montessori-based activities on eating ability and nutritional status is recommended.

The findings may serve to increase awareness of this problem among healthcare professionals in LTCFs. Further research is contemplated to investigate whether early identification makes a difference in treatment choices and outcomes.

Montessori-based activities could provide caregivers with an evidence-based nursing strategy to deal with eating difficulties of people with dementia.

The quality of end-of-life care for Taiwanese cancer decedents was substantially inferior to that previously reported and to that recommended as benchmarks for not providing overly aggressive care near the end of life.

Controlling for patient demographics and cormorbidity burden, EOL care in Taiwan was more aggressive for patients with cancer with highly malignant and extensive diseases, for patients with oncologists as primary care providers, or in hospitals with abundant health care resources. Health policies should aim to ensure that all patients receive treatments that best meet their individual needs and interests and that resources are devoted to care that produces the greatest health benefits.

This study confirms that a blending of traditional Chinese medicine and a Western activities program would be useful in elderly care and that in-service training for formal caregivers in the use of these interventions would be beneficial for patients

BackgroundOne of the most common symptoms observed in patients with dementia is agitation, and several non-pharmacological treatments have been used to control this symptom. However, because of limitations in research design, the benefit of non-pharmacological treatments has only been demonstrated in certain cases. The purpose of this study was to compare aroma-acupressure and aromatherapy with respect to their effects on agitation in patients with dementia.MethodsIn this experimental study, the participants were randomly assigned to three groups: 56 patients were included in the aroma-acupressure group, 73 patients in the aromatherapy group, and 57 patients in the control group who received daily routine as usual without intervention. The Cohen-Mansfield Agitation Inventory (CMAI) scale and the heart rate variability (HRV) index were used to assess differences in agitation. The CMAI was used in the pre-test, post-test and post-three-week test, and the HRV was used in the pre-test, the post-test and the post-three-week test as well as every week during the four-week interventions.ResultsThe CMAI scores were significantly lower in the aroma-acupressure and aromatherapy groups compared with the control group in the post-test and post-three-week assessments. Sympathetic nervous activity was significantly lower in the fourth week in the aroma-acupressure group and in the second week in the aromatherapy group, whereas parasympathetic nervous activity increased from the second week to the fourth week in the aroma-acupressure group and in the fourth week in the aromatherapy group.ConclusionsAroma-acupressure had a greater effect than aromatherapy on agitation in patients with dementia. However, agitation was improved in both of the groups, which allowed the patients with dementia to become more relaxed. Future studies should continue to assess the benefits of aroma-acupressure and aromatherapy for the treatment of agitation in dementia patients.Trial registrationChiCTR-TRC-14004810; Date of registration: 2014/6/12

Aims. The aim of this study was to investigate the risk factors of institutionalised older people for developing low food intake. Background. Eating difficulties among patients with dementia have been identified in western society and typically progress as dementia advances. Findings from previous studies reflect that low food intake or weight loss might not be a consequence of people with dementia being unable or unwilling to eat independently. Design. The study consisted of observers' training and mealtime observations. Each data collector received two days of didactic and clinical training. Observation was done for two days during lunch and dinner. Methods. Four hundred seventy-seven participants were selected from residents with dementia at nine dementia special care units in licensed long-term care facilities in northern and central Taiwan. Data were collected using the Barthel index, MiniMental State Examination (MMSE), and the Edinburgh Feeding Evaluation in Dementia (EdFED) scale.Results. The prevalence of low food intake at meals in residents with dementia in LTCF's was 30AE7%. Eating difficulty, no feeding assistance, moderate dependence, fewer family visits, being female and older, were six independent factors associated with low food intake after controlling for all other factors. Conclusion. Nursing staff need to assess residents' feeding ability to continue to self-feed. Also, to supervise the feeding of residents with moderate dependency and provide appropriate verbal or physical assistance at meal times is recommended. Relevance to clinical practice. Constructing strategies to encourage families to visit their older relatives in institutions is recommended.