Supporting Mealtime Participation Among People Living With Dementia at Home: Challenges and Strategies for Caregivers.

IF 4.6 2区 医学 Q1 GERONTOLOGY
Lisa A Juckett, Mequeil L Howard, Beth E Fields, Shannon E Jarrott, Lorraine C Mion, Kali S Thomas
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Abstract

Background and objectives: Approximately 60% of people living with dementia at home are unable to routinely participate in mealtime activities (e.g., eating, safe food preparation), warranting assistance to ensure people with dementia meet their health and nutritional needs. The purpose of this study was to characterize these barriers to mealtime participation and identify potential caregiver-led strategies to enhance mealtime activities.

Research design and methods: We used a qualitative descriptive approach and obtained semistructured interview data from (a) allied health professionals and (b) community-based nutrition program providers who frequently serve people with dementia. Interview data were examined by means of directed content analysis and framework methodology until data saturation was reached. Codes from our analysis were categorized according to constructs drawn from the Socio-Ecological Model for Developing and Implementing Comprehensive Dementia Care.

Results: Data were obtained from 20 participants who attributed common mealtime participation barriers to: impairments in functional status, cognitive status deficits, a lack of caregiver knowledge and skills, and unsafe living conditions. Caregiver-led strategies to overcome these barriers included: reducing auditory and visual distractions, providing written cues to perform mealtime activities, eliminating clutter and fall risk hazards, and leveraging community-based nutrition program providers (e.g., home-delivered meal providers).

Discussion and implications: People with dementia face several eating and mealtime participation obstacles. Caregiver-led strategies implemented by family, friends, or community-based nutrition program providers may enhance mealtime activities at home. Findings point to opportunities to develop decision-making tools and resources for caregivers to optimize the health and nutrition of people with dementia.

支持痴呆症患者在家用餐:照顾者面临的挑战和策略。
背景和目标:约有 60% 的居家痴呆症患者无法例行参与进餐时间活动(如进食、安全的食物准备),因此需要帮助以确保痴呆症患者满足其健康和营养需求。本研究的目的是分析这些妨碍患者参与进餐时间的障碍,并找出以护理人员为主导的潜在策略,以加强进餐时间的活动:我们采用了定性描述法,并从以下人员处获得了半结构化访谈数据:(a)专职医疗人员;(b)经常为痴呆症患者提供服务的社区营养计划提供者。访谈数据通过定向内容分析和框架方法进行研究,直到数据达到饱和为止。我们根据 "制定和实施全面痴呆症护理的社会生态模型 "中的构架对分析得出的代码进行了分类:我们从 20 位参与者那里获得了数据,他们将常见的进餐时间参与障碍归因于:功能状态受损、认知状态缺陷、缺乏护理知识和技能以及不安全的生活条件。由护理人员主导的克服这些障碍的策略包括:减少听觉和视觉干扰、提供进餐时间活动的书面提示、消除杂乱和跌倒危险,以及利用社区营养计划提供者(如上门送餐服务提供者):痴呆症患者在进食和用餐时会遇到一些障碍。由家人、朋友或社区营养计划提供者实施的由护理者主导的策略可能会加强患者在家进餐时的活动。研究结果表明,有机会为护理人员开发决策工具和资源,以优化痴呆症患者的健康和营养。
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来源期刊
Gerontologist
Gerontologist GERONTOLOGY-
CiteScore
11.00
自引率
8.80%
发文量
171
期刊介绍: The Gerontologist, published since 1961, is a bimonthly journal of The Gerontological Society of America that provides a multidisciplinary perspective on human aging by publishing research and analysis on applied social issues. It informs the broad community of disciplines and professions involved in understanding the aging process and providing care to older people. Articles should include a conceptual framework and testable hypotheses. Implications for policy or practice should be highlighted. The Gerontologist publishes quantitative and qualitative research and encourages manuscript submissions of various types including: research articles, intervention research, review articles, measurement articles, forums, and brief reports. Book and media reviews, International Spotlights, and award-winning lectures are commissioned by the editors.
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