Supporting people with dementia to eat

Abstract

The aim of this systematic review was to identify the best ways of supporting people with dementia to eat. Five electronic databases were searched, with a date range from January 2004 to July 2015. Following screening of the 233 studies identified, 22 were included in the final analysis. The study interventions focused on educational programmes, environmental or routine changes, and assistance with eating, with the strongest evidence shown in the more complex educational programmes for people with dementia. The evidence suggests that staff who support people with dementia to eat should undertake face-to-face education programmes and aim to give people enough time when helping them to eat. However, cultural change may be needed to ensure individual assessments are carried out to identify those having difficulty eating, and to ensure they are afforded enough time to eat their meals.

Overview of systematic reviews: Effectiveness of non‐pharmacological interventions for eating difficulties in people with dementia

“…Twelve systematic reviews (Abdelhamid et al., 2016; Bunn et al., 2016; Fetherstonhaugh, Haesler, & Bauer, 2019; Hanson, Ersek, Gilliam, & Carey, 2011; Jackson, Currie, Graham, & Robb, 2011; Leah, 2016; Watson & Green, 2006; Wen, Jooyoung, & Thomas, 2014; Whear et al., 2014; Woodbridge et al., 2018; Yakimicki et al., 2019; Yi‐Hui et al., 2014) evaluated the effectiveness of environmental modifications, including lighting and contrast (7/12), home‐like environment (4/12), fish aquarium in dining area (6/12), music played during mealtimes (10/12), seated in the same location (1/12), and shared mealtime with others (3/12). According to the results, almost all of reviews showed that environmental modifications could be beneficial to increase food and drink intake.…”

“…Seven systematic reviews (Bunn et al., 2016; Fetherstonhaugh et al., 2019; Herke et al., 2018; Jackson et al., 2011; Leah, 2016; Sheppard, McArthur, & Hitzig, 2016; Wen et al., 2014) evaluated the effectiveness of education/training, including education and nutrition promotion programme for PWD (2/7), spaced retrieval activities training for PWD (5/7), Montessori‐based activities training for PWD (6/7), caregiver education (5/7), and feeding skills training programme for caregivers (4/7). Based on the result from Herke et al.…”

“…The other review (Bunn et al., 2016) reported education and nutrition promotion programme for PWD had a positive effect on weight and MNA score, however, the level of evidence was not high and the result needed to be further verified (Bunn et al., 2016). And three reviews (Fetherstonhaugh et al., 2019; Herke et al., 2018; Leah, 2016) reported spaced retrieval activities training could improve food and drink intake. Over half of reviews indicated it brought a positive effect on nutritional status, while consistent conclusions whether it worked for eating behaviours were not drawn.…”

Nutrition Care for Residents with Dementia in Long-Term Care Homes: Umbrella Review of Care Aide and Registered Dietitian Services

“…A wide variety of interventions were considered in these reviews. Generally, interventions included use of oral supplementation/food fortification (12,15,16,18), eating assistance (12,13,(16)(17)(18)(19), environmental modification (13,14,16,18,19,21); staff education or training (16)(17)(18)(19); and food service/food delivery modification (14,16,20). Outcomes considered varied considerably including a range of psychological/psychosocial/behavioural measures, anthropometric measures such as weight and BMI, intake measures, functional measures such as eating ability/performance, satisfaction/perspective, and quality of life measures ( Table 2).…”

“…The broad, general nature of the recommendations was likely due to the relatively low quality of evidence, heterogeneity of findings, and the wide range of interventions and outcomes considered. Although few studies differentiated between types of staff, recommendations regarding staff in LTC settings included the need for increased training and education (12,14,(16)(17)(18)(19), and increased staff time/involvement (12,15). Two reviews made recommendations specific to care aides, calling for appropriate training/education (18,19) and one review recommended that care aides provide one-onone assistance to residents with dementia (19).…”