title: Prevention of unintentional weight loss in nursing home residents: a controlled trial of feeding assistance.
abstract: OBJECTIVE
  To determine the effects of a feeding assistance intervention on food and fluid intake and body weight.
  
  
  METHODS
  Crossover controlled trial.
  
  
  METHODS
  Four skilled nursing homes (NHs).
  
  
  METHODS
  Seventy-six long-stay NH residents at risk for unintentional weight loss.
  
  
  METHODS
  Research staff provided feeding assistance twice per day during or between meals, 5 days per week for 24 weeks.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of General Internal Medicine and Public Health, Center for Quality Aging, School of Medicine, Vanderbilt University, Nashville, Tennessee 37232-2400, USA. Sandra.Simmons@Vanderbilt.edu
authors.forename: Sandra F
authors.initials: SF
authors.lastname: Simmons
authors.forename: Emmett
authors.initials: E
authors.lastname: Keeler
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhuo
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Hickey
authors.forename: Hui-Wen
authors.initials: HW
authors.lastname: Sato
authors.forename: John F
authors.initials: JF
authors.lastname: Schnelle
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D019587:Dietary Supplements; D002149:Energy Intake; D005248:Feeding Methods; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D015596:Nutrition Assessment; D013996:Time and Motion Studies; D016896:Treatment Outcome; D015431:Weight Loss