Experimental Comparison of Efficacy for Three Handfeeding Techniques in Dementia. Issue 4 (6th February 2017)

• Record Type: Journal Article
• Authors: Batchelor‐Murphy, Melissa K.; McConnell, Eleanor S.; Amella, Elaine J.; Anderson, Ruth A.; Bales, Connie W.; Silva, Susan; Barnes, Angel; Beck, Cornelia; Colon‐Emeric, Cathleen S.
• Is Part Of: Journal of the American Geriatrics Society. Volume 65:Issue 4(2017:Apr.)
• Page Start: e89
• Page End: e94
• Publication Date: 2017-02-06
• Subjects: handfeeding -- dementia -- feeding behaviors -- mealtime difficulties -- nursing home; Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.14728
• Languages: English
• ISSNs: 0002-8614

Abstract

Abstract : Background: Nursing home (NH) residents who require assistance during mealtimes are at risk for malnutrition. Supportive handfeeding is recommended, yet there is limited evidence supporting use of a specific handfeeding technique to increase meal intake. Objectives: To compare efficacy of three handfeeding techniques for assisting NH residents with dementia with meals: Direct Hand (DH), Over Hand (OH), and Under Hand (UH). Design: A prospective pilot study using a within‐subjects experimental Latin square design with randomization to one of three handfeeding technique sequences. Setting and Participants: 30 residents living with advanced dementia in 11 U.S. NHs. Measurements: Time required for assistance; meal intake (% eaten); and feeding behaviors, measured by the Edinburgh Feeding Evaluation in Dementia (EdFED) scale. Intervention: Research Assistants provided feeding assistance for 18 video‐recorded meals per resident (N = 540 meals). Residents were assisted with one designated technique for 6 consecutive meals, changing technique every 2 days. Results: Mean time spent providing meal assistance did not differ significantly between techniques. Mean meal intake was greater for DH (67 ± 15.2%) and UH (65 ± 15.0%) with both significantly greater than OH (60 ± 15.1%). Feeding behaviors were more frequent with OH (8.3 ± 1.8%), relative to DH (8.0 ± 1.8) and UH (7.7 ± 1.8). Conclusion: All three techniques are time neutral. UH and DH are viable options to increase meal intake among NH residents with advanced dementia and reduce feeding behaviors relative to OH feeding.