Eating Difficulties among Older Adults with Dementia in Long-Term Care Facilities: A Scoping Review

Abstract

This paper reports a scoping review of the literature on eating difficulties among older adults with dementia in long-term care facilities to identify key concepts, methods of measuring outcomes, interventions, and related factors. A scoping review was performed using the bibliographic databases PubMed, CINAHL, PsycINFO, and Cochrane Library. A combination of keywords and subject headings related to eating or feeding difficulties was used. Inclusion criteria were limited to materials published in English. A total of 1070 references were retrieved, of which 39 articles were selected after applying the inclusion and exclusion criteria. Articles that met the criteria were published between 1987 and 2020. “Eating disabilities” have been defined as problems related to choosing food and/or the ability to get food to one’s mouth, chew, and swallow. Interventions for eating difficulties described in the literature include spaced retrieval training, Montessori training, and feeding skill training. Intrapersonal, interpersonal, and environmental factors related to eating difficulties were identified. This scoping review will provide direct care workers, nursing educators, and administrators with an overview of eating performance and a broad understanding of eating difficulties for older adults with dementia in long-term care facilities.

Research Hotspots and Trends in Music Therapy Intervention for Patients With Dementia: A Bibliometrics and Visual Analysis of Papers Published From 2010 to 2021

“…The physical and mental health of the sufferer is also impaired by life disorders associated with eating difficulties and a strong sense of loneliness ( 31 ). Different types of eating difficulties caused by cognitive impairment have been reported to contribute to malnutrition in dementia patients and to increase their risk of respiratory infections ( 32 ). Several studies have shown that a lack of social communication in patients with dementia is associated not only with higher mortality but also with increased BPSD and psychological symptoms such as depression and loneliness ( 33 , 34 ), among which loneliness and isolation are closely associated with dementia.…”

Development of mealtime difficulty scale for older adults with dementia in long-term care facilities

“…We reviewed articles on eating difficulties among older adults with dementia in LTCF in our scoping review and developed items using the final 39 articles. In previous studies [11], the initial total number of items was 31. The developed MDSD was designed to allow direct care providers to answer the questionnaire for the older adult with dementia they mainly care for.…”

“…Thus, these previous standardized measures only reflect the personal aspects of older adults with dementia through their measurement items and focus only on limited functionality due to cognitive declines in older adults with dementia. However, these instruments fail to consider the behavioral and psychological symptoms of dementia (BPSD), environmental, and interpersonal phenomena relating to that may significantly shape dietary impairments among older adults with dementia [11]. Sociocultural contexts, such as health and medical policies and services and dietary habits related to food type, can influence dietary behavior during aging [12,13].…”

“…These problems are connected to physical, cognitive, behavioral, social, environmental, and cultural factors [13,14]. Based on the results of scoping reviews, intrapersonal (cognitive and physical function), interpersonal (attitude toward caregiver meals), and environmental domains (diet) frequently affected mealtime difficulties [11,15]. Additionally, the scoping review concluded that it is difficult to measure in detail by using just eight or nine items in the existing instruments [11].…”

“…Based on the results of scoping reviews, intrapersonal (cognitive and physical function), interpersonal (attitude toward caregiver meals), and environmental domains (diet) frequently affected mealtime difficulties [11,15]. Additionally, the scoping review concluded that it is difficult to measure in detail by using just eight or nine items in the existing instruments [11]. Social ecological models (SEM) that apply to mealtime difficulties can optimize the health and well-being of dementia patients.…”