Nutrition and dementia care: Developing an evidence-based model for delivering person-centred care in nursing homes.
Start date: 29 October 2016
Eating and drinking difficulties are a major factor contributing to ill-health, frailty and reduced quality of life for people living with dementia. Consequently there are complex challenges for the caregiver in ensuring nutritional needs are met. Whilst a number of interventions have been identified to support food and drink intake, there have been no systematic studies to understand the factors that improve nutritional care from the perspectives of all those responsible for delivering care in nursing homes. The aim of this study was to develop a conceptual model to understand eating and drinking for people with dementia from a range of providers, thus supporting credibility from the perspective of the end-user. An exploratory qualitative design using purposive sampling was used. A series of nine focus groups and five semi-structured interviews were conducted with 50 participants who were involved or who have a level of responsibility for providing food and drink and nutritional care in nursing homes (care home staff including nurses, care assistants, managers, food service providers n=30, family carers n=8, dietitians n=3, speech and language therapists n=9). Discussions followed an agreed structure, were tape recorded, transcribed and analysed using thematic analysis.
The core themes that emerged were person-centred nutritional care; availability of food and drink; tools, resources and environment; relationship to others when eating and drinking; participation in activities; consistency of care and provision of information. The findings have informed the development of a collaboratively developed, person-centred model for quality improvements in nutritional care to design new education and training tools and be readily translated into existing programmes. Further research is needed to evaluate whether these evidence-informed approaches can be implemented successfully and adopted into practice and policy contexts and demonstrate effectiveness for people living with dementia.