Nursing home (NH) residents who require assistance during mealtimes are at risk for malnutrition. Supportive handfeeding is recommended, yet there is limited evidence supporting use of a specific handfeeding technique to increase meal intake.
To compare efficacy of three handfeeding techniques for assisting NH residents with dementia with meals: Direct Hand (DH), Over Hand (OH), and Under Hand (UH).
A prospective pilot study using a within-subjects experimental Latin square design with randomization to one of three handfeeding technique sequences.
Time required for assistance; meal intake (% eaten); and feeding behaviors, measured by the Edinburgh Feeding Evaluation in Dementia (EdFED) scale.
Research Assistants provided feeding assistance for 18 video-recorded meals per resident (N=540 meals). Residents were assisted with one designated technique for 6 consecutive meals, changing technique every two days.
Mean time spent providing meal assistance did not differ significantly between techniques. Mean meal intake was greater for DH (67±15.2%) and UH (65±15.0%) with both significantly greater than OH (60±15.1%). Feeding behaviors were more frequent with OH (8.3±1.8%), relative to DH (8.0±1.8) and UH (7.7±1.8).