Individualizing Nutritional Care With Between-Meal Snacks for Nursing Home Residents

Diaper-zero program (prompted voiding care) improves diaper use in nursing home residents

“…This study identified, at the start of this program, that higher daily energy and water intake was related with higher physical activity, lower nursing care level, and a lower diaper usage rate. Sarcopenia and frailty are associated with low energy intake in nursing home residents (19)(20)(21). Dehydration is also shown to negatively affect muscle endurance, power, and strength (22,23).…”

Impact of Cognition and Handfeeding Assistance on Nutritional Intake for Nursing Home Residents

“…1,[25][26][27][28] These findings support earlier studies that have indicated NH residents with dementia are at greater risk for low intake compared to residents without dementia. 9,12,29 Documenting overall meal intake percentage is common in clinical practice; this study is novel in asking CNAs to document the level of feeding assistance provided for each meal. Residents with dementia more often need help with eating in the form of verbal and visual cueing, focus on eating may wander to other environmental stimuli, and residents' attention may need to be redirected to eating.…”

“…Subsequent research studies demonstrated that 64-80% of all residents were at risk for weight loss and malnutrition, and those with dementia are at higher risk than those without dementia. [9][10][11][12] Over half of NH residents have some form of cognitive impairment, and most with moderate or severe dementia. 13 Dementia is a disease that progressively robs an individual of the cognitive and physical abilities needed to complete their own activities of daily living (ADL).…”

“…The level of support required by a resident can vary over the course of a day, and day to day. 6,7,9,16 When providing daily care, CNAs typically know if a resident is dependent on the staff for meal assistance and the level of assistance required. However, how much and what type of assistance to provide to residents who are "set-up only" is left to the CNAs available time and individual judgement, resulting in a wide range of assistance offered.…”

“…The mismatch of support to resident ability for each meal sets the stage for resident unplanned weight loss and malnutrition; in fact, the amount and quality of feeding assistance provided has been identified as the most powerful indicator of meal intake. 9 Weight loss is commonly treated with orders for high-density protein supplements, and/or snacks being added to the care plan in an attempt to improve total intake. [5][6][7]16 Between meal snacks have been found to be an important aspect of total food intake as well as the type of feeding assistance provided.…”