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“If they don’t like you, they are not going to eat for you”: individual and interpersonal factors affecting certified nursing assistants’ ability to provide mealtime assistance to residents with dementia
- Authors:
- DOUGLAS Joy W., et al
- Journal article citation:
- Gerontologist, 61(4), 2021, pp.552-562.
- Publisher:
- Oxford University Press
Background and Objectives: In long-term care facilities in the United States, certified nursing assistants (CNAs) provide mealtime assistance to residents with dementia, a task that substantially increases caregiver burden due to the time and attention required. The aim of this qualitative study was to explore the individual and interpersonal barriers and facilitators CNAs experience when providing mealtime assistance to residents with dementia. Research Design and Methods: Focus group questions were developed based on the corresponding levels of the Social Ecological Model. Using purposive sampling, 9 focus groups were conducted with 53 CNAs who had at least 1 year of experience as a CNA working with older adults. Focus groups were audio-recorded and transcribed verbatim. Data were analyzed using the directed content analysis approach. Results: CNAs reported individual skills, training, and personal characteristics that affected their ability to provide mealtime assistance. At the interpersonal level, CNAs identified their relationships with residents, residents’ family members, and other health care professionals as factors that affect their ability to provide mealtime assistance. Discussion and Implications: These findings provide evidence for strategies that administrators can utilize to reduce caregiver burden by improving the mealtime experience. First, CNAs need adequate training, particularly to develop communication skills. Developing verbal communication skills may improve interpersonal relationships between CNAs and residents’ family members and other coworkers. Developing nonverbal communication skills may foster an improved relationship between CNAs and their residents with dementia. Future research should evaluate interventions that seek to improve these skills to determine their impact on the mealtime experience. (Edited publisher abstract)
The use of fortified foods to treat malnutrition among older adults: a systematic review
- Authors:
- DOUGLAS Joy W., LAWRENCE Jeannine C., KNOWLDEN Adam P.
- Journal article citation:
- Quality in Ageing and Older Adults, 18(2), 2017, pp.104-119.
- Publisher:
- Emerald
Purpose: Food fortification with common kitchen ingredients has been suggested to improve nutritional intake. The purpose of this paper was to systematically review the efficacy of food fortification on calorie and protein intake among older adults. Design/methodology/approach: A systematic search was conducted using Boolean search logic and seven research databases to identify interventions using fortified foods to increase calorie and protein intake among older adults. Ten studies published in English since 1996 were eligible for inclusion. Study quality was evaluated using an adapted Modified Jadad Questionnaire. Findings: Food fortification was associated with increased calorie intake in eight studies, increased protein intake in five studies, and increased body weight in three studies. However, studies were limited by lack of rigor in methodology and small sample sizes. Originality/value: Food fortification may improve calorie and protein intake, but results are limited by study weaknesses. Additionally, it is unclear whether improved intake results in improved clinical outcomes. (Publisher abstract)