Comparison of Hand Feeding Techniques for Persons With Dementia

Comparison of Hand Feeding Techniques for Persons With Dementia Living in the Nursing Home

The purpose of this study is to test three hand feeding techniques that can be used to provide feeding assistance to persons with dementia - direct hand feeding, hand-over-hand feeding, and hand-under-hand feeding.

Proposed Aim 1: To collect pilot data related to using three hand feeding techniques for feeding persons with dementia (PWD) in the nursing home (NH) setting: (1) direct hand feeding; (2) hand-over-hand feeding; and, (3) hand-under-hand feeding. Primary outcomes are impact on frequency of aversive feeding behaviors, meal intake, and time spent assisting with feeding.

Proposed Aim 2: Evaluate implementation of the hand feeding intervention for larger randomized study of feeding techniques.

Aim 2a: Conduct a process evaluation for method of recruiting, screening, and obtaining informed consent of legally authorized representatives (LARs)/ assent of PWD.

Aim 2b: Establish fidelity to treatment for all three hand feeding interventions.

Inclusion Criteria:

• Resident of nursing home 6 weeks prior to intervention delivery
• 60+ years old
• Have a legally authorized representative to provide informed consent
• medical diagnosis of dementia
• required extensive assistance to total dependence for feeding
• Brief Interview for Mental Status (BIMS) score of 0-12

Exclusion Criteria:

• Positive diagnosis of Human Immunodeficiency Virus (HIV), Parkinson's, and/or Traumatic Brain Injury
• Any swallowing disorder
• Presence of feeding tube that is sole source for meal delivery
• Significant auditory or visual impairment