Factors influencing the proportion of food consumed by nursing home residents with dementia.
BACKGROUND
Assessment of and interventions for promoting eating in persons with late-stage dementia have primarily focused on facilitation of safe feeding and methods to promote ingestion of nutrients via several routes. Using Social Exchange Theory, this study examined how the quality of the interaction between care giver and care receiver influenced the proportion of food consumed by persons with late-stage dementia.


METHODS
Fifty-three dyads composed of nursing home residents with late-stage dementia and Certified Nursing Assistants (CNAs) were observed during the breakfast meal. The proportion of food consumed by the residents was measured by weight. The study included measures of the quality of interaction between the resident and the CNA (Interaction Behavior Measure-Modified (IBM-M) and the IBM), CNA empathy (Interpersonal Reactivity Index), and CNA power (Control subscale of the FIRO-B).


RESULTS
Specific resident behaviors and the CNA's ability to allow another person to control a relationship were most predictive of the variance in the proportion of food consumed (R2 = .41; F(3,49) = 12.54; P < .001). The quality of the resident-CNA interaction accounted for 32% of the variance in the proportion of food consumed. One aspect of power was correlated significantly to the proportion of food consumed whereas CNA empathy was not.


CONCLUSIONS
Because eating is the most social of all ADLs and is culturally bound, clinicians need to examine the interactional components of meals within the caregiving dyad when a person with late-stage dementia fails to ingest adequate nutrients.
College of Nursing, Medical University of South Carolina, Charleston 29425, USA.
E J
EJ
Amella
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003704:Dementia / Q000150:complications*; D004645:Empathy; D002149:Energy Intake; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009728:Nursing Assistants / Q000523:psychology*; D009735:Nursing Homes; D010358:Patient Participation; D011209:Power, Psychological; D011237:Predictive Value of Tests; D011369:Professional-Patient Relations; D012307:Risk Factors