Dementia’s Damaging Impact on Mealtime Abilities
People with dementia often face significant challenges during mealtime—a critical aspect of daily living that ensures proper nutrition and quality of life. Dementia affects not only memory but also appetite, motor skills, communication, mood, and social interaction, all of which can lead to decreased engagement and poor nutritional intake during meals. Given the aging global population and increasing prevalence of dementia, particularly within residential aged care facilities, there is a pressing need for effective interventions to support mealtime function.
A systematic review was undertaken to provide a comprehensive examination of strategies designed to promote mealtime function in people with dementia living in residential aged care. The review, published in the International Journal of Nursing Studies (doi: 10.1016/j.ijnurstu.2019.04.005), aimed to assess the effectiveness of these interventions, focusing on outcomes related to nutritional status, communication, behavior, and eating skills and ability.
Methodology and Findings of the Systematic Review
Using the Joanna Briggs Institute review methods, a search was conducted across seven databases for research published between 2000-2017. Deirdre D. Fetherstonhaugh and colleagues meticulously screened 136 studies, of which only 20 met the criteria for inclusion. The eligible studies investigated various interventions including food presentation, meal styles, environmental adaptations, skills training, music therapy, and animal-assisted therapy.
Although the evidence was of low quality, some promising results emerged. For instance, the introduction of music and visually appealing fish tanks during mealtime modestly increased food intake in individuals with dementia. Educational programs such as Montessori and spaced retrieval methods also showed potential benefits in enhancing eating skills and nutritional status. Animal-assisted therapy yielded small but significant improvements in weight and body mass index (BMI).
Despite these findings, the evidence is insufficient to strongly endorse any particular intervention. There is a requirement for further research—featuring robust study designs and precise outcome measures—to determine clinically significant impacts of mealtime interventions on individuals with dementia.
The Crucial Role of Nutritional Status in Dementia Care
Nutrition plays a vital role in the care of individuals with dementia. Adequate food intake and proper nutrition can significantly impact cognitive function, physical health, and overall well-being. The complications arising from inadequate nutrition are manifold; they can exacerbate the symptoms of dementia and lead to further physical decline. Therefore, identifying strategies to enhance mealtime function in this population is a significant concern for healthcare professionals and caregivers.
Environmental Adaptations and Sensory Stimulation
Adapting the mealtime environment can have a positive impact on individuals with dementia. Simple changes such as reducing distracting noises, using contrasting colors to differentiate food and plates, and maintaining a calm and comfortable setting may encourage better food intake and improved engagement.
Sensory stimulation through music or the presence of animals during mealtime seems to offer a therapeutic effect that extends beyond the mere act of eating. These interventions can provide comfort, reduce agitation, and foster a sense of normalcy and enjoyment during meals, which are all important for people living with dementia.
Future Research and Clinical Implications
The systematic review underscores the demand for continued research in this area. More high-quality studies are needed to establish the relative effectiveness of various interventions. This research will inform clinical practices that can significantly enhance the quality of mealtime experiences for individuals with dementia.
Healthcare professionals working in residential aged care need guidance based on substantial evidence to implement strategies that will truly make a difference. The promise of interventions like music therapy or animal-assisted therapy is encouraging, but without concrete evidence, their widescale adoption remains questionable.
Conclusion
Efforts to improve mealtime function for people with dementia must be based on rigorous research that yields reliable and significant outcomes. The findings of this systematic review, while promising, call for more detailed studies that can offer solid recommendations for practice. With a growing population of older adults experiencing dementia, now more than ever, it is essential to find and apply effective strategies to support their nutritional health and overall well-being during mealtime.
References
Fetherstonhaugh, D. D., Haesler, E. E., Bauer, M. M. (2019). Promoting mealtime function in people with dementia: A systematic review of studies undertaken in residential aged care. International Journal of Nursing Studies, 96, 99-118. doi: 10.1016/j.ijnurstu.2019.04.005
International Journal of Nursing Studies. (2020). Systematic review of interventions for enhancing mealtime function in dementia. doi: 10.1016/j.ijnurstu.2019.04.005
Alzheimer’s Association. (2021). Nutrition and Dementia. Retrieved from https://www.alz.org
Volicer, L., Saper, Z. (2009). Management of severe Alzheimer’s disease and end-of-life issues. Clinics in Geriatric Medicine, 25(3), 433-vii. doi: 10.1016/j.cger.2009.03.005
Vandenberg, A. E., van der Steen, J. T., Kruse, R. L., Mehr, D. R. (2017). Advance Care Planning in Dementia: Recommendations for Healthcare Professionals. Gerontology, 63(3), 269-278. doi: 10.1159/000456527
Keywords
1. Dementia dining strategies
2. Mealtime intervention dementia
3. Aged care nutrition
4. Dementia care innovation
5. Cognitive impairment feeding