Evaluating Nonverbal Behavior of Individuals with Dementia During Feeding: A Survey of the Nursing Staff in Residential Care Homes for Elderly Adults. Issue 12 (14th November 2015)

• Record Type: Journal Article
• Authors: Kuehlmeyer, Katja; Schuler, Anna F.; Kolb, Christian; Borasio, Gian Domenico; Jox, Ralf J.
• Is Part Of: Journal of the American Geriatrics Society. Volume 63:Issue 12(2015:Dec.)
• Page Start: 2544
• Page End: 2549
• Publication Date: 2015-11-14
• Subjects: dementia -- ethics -- treatment decisions -- artificial nutrition and hydration -- personal autonomy; Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.13822
• Languages: English
• ISSNs: 0002-8614

Abstract

Abstract : Objectives: To determine how nursing staff evaluate nonverbal behavior related to hand and tube feeding of residents with dementia. Design: Cross‐sectional survey. Setting: A stratified sample of nurses and nursing assistants in residential nursing homes in a major German city. Participants: Nursing staff members (N = 131) in 12 nursing homes. Measurements: Nursing staff perception of nonverbal behavior of residents with dementia in response to hand and tube feeding. Results: Ninety‐three percent of survey participants considered the nonverbal behavior of residents with advanced dementia crucial for decisions about artificial nutrition and hydration (ANH). The same percentage had at some point encountered residents who did not open their mouths when feeding was attempted. Fifty‐three percent of the participants interpreted residents' expressions of pleasure while eating as a will to live. The most frequent interpretation of residents' aversive behavior was discomfort. When residents did not open their mouth during nurse's hand feeding, 41% of the participants inferred a will to die. Conclusion: Most nurses and nursing assistants consider residents' behavior during hand or tube feeding to be important, but their interpretations are heterogeneous. Various professional caregivers assume a will to live or die. Further reflection is necessary to determine how behavioral expressions should be factored into treatment decisions.