Effectiveness of interventions to directly support food and drink intake in people with dementia: systematic review and meta-analysis
OBJECTIVES To determine the effects of a feeding assistance intervention on food and fluid intake and body weight. DESIGN Crossover controlled trial. SETTING Four skilled nursing homes (NHs). PARTICIPANTS Seventy-six long-stay NH residents at risk for unintentional weight loss. INTERVENTION Research staff provided feeding assistance twice per day during or between meals, 5 days per week for 24 weeks. MEASUREMENTS Research staff independently weighed residents at baseline and monthly during a 24-week intervention and 24-week control period. Residents' food and fluid intake and the amount of staff time spent providing assistance to eat was assessed for 2 days at baseline and 3 and 6 months during each 24-week period. RESULTS The intervention group showed a significant increase in estimated total daily caloric intake and maintained or gained weight, whereas the control group showed no change in estimated total daily caloric intake and lost weight over 24 weeks. The average amount of staff time required to provide the interventions was 42 minutes per person per meal and 13 minutes per person per between-meal snack, versus usual care, during which residents received, on average, 5 minutes of assistance per person per meal and less than 1 minute per person per snack. CONCLUSION Two feeding assistance interventions are efficacious in promoting food and fluid intake and weight gain in residents at risk for weight loss. Both interventions require more staff time than usual NH care. The delivery of snacks between meals requires less time than mealtime assistance and thus may be more practical to implement in daily NH care practice.