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Behavioral Challenges and Adaptive Strategies in Providing Mealtime Care to Residents With Dementia: A Qualitative Study of Nursing Home Clinical and Administrative Staff

Year: 2025

Type: article

Abstract: This study examined how nursing home staff adapt to challenging mealtime behaviors in residents with dementia, such as turning away or refusing food. Ten focus groups were conducted with 52 clinical and administrative staff from three southeastern U.S. nursing homes. Transcripts were analyzed using four key codes: feeding behaviors, interventions, training, and communication. Staff described a range of mealtime challenges, including cognitive and functional decline, dysphagia, and elopement. Feeding-related behaviors like refusing to eat reflect the complexity of care required. Staff reported adapting interventions based on residents' abilities, their own interactions, or environmental factors. Most strategies aligned with evidence-based practices, though one novel tactic involved "sprinkling sugar" to stimulate appetite. Findings suggest that reframing feeding behaviors as communication may improve care and reinforces the need for tailored interventions. Differences in staff perspectives emphasize the value of cross-role collaboration in managing mealtime challenges and improving outcomes for residents with dementia.

Source: Journal of Applied Gerontology

DOI: 10.1177/07334648251391869

Authors: Melissa Batchelor, Sana Smaoui, Lígia Passos, Wen Liu

Institutions: George Washington University, Kuwait University, University of Aveiro, University of Iowa

Language: English

Topic: Geriatric Care and Nursing Homes

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funders: National Institutes of Health, National Institute on Aging, National Institute of Nursing Research