Weight Loss Prevention
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Implementation of Nutritional Interventions in Long Term Care
Sandra F. Simmons and John F. Schnelle, 2003, in Alzheimer's Care Quarterly: Translating Psychosocial Research into Practice; 4(4):286-296.
This paper reviews recent research findings that underscore the need to improve the adequacy and quality of feeding assistance in nursing homes. Additionally, based on results from Borun Center research, the authors describe a non-medical intervention that has been shown to significantly improve food and fluid consumption among nursing home residents who otherwise would be at risk for undernutrition and weight loss due to low intake. The implementation process involves four steps:
- Identify residents at risk for undernutrition and weight loss due to low intake. These residents typically eat less than 75% of most meals
- Implement a two-day, or six-meal, trial of feeding assistance with each at-risk resident to determine whether he or she is responsive to feeding assistance. Residents who increase their intake by 15% or more should continue to receive the mealtime feeding assistance intervention. Unresponsive residents should be offered between-meal snacks at least twice a day (and ideally three times daily) in order to increase their food and fluid intake.
- Staffing adjustments should be made as necessary to meet the feeding assistance needs of at-risk residents both during and between meals.
- Supervisory staff should regularly monitor mealtime and snack routines to ensure that nurse aides or other designated staff members continue to provide adequate feeding assistance to targeted residents. Supervisors can use a standardized observational protocol described in this paper to effectively manage the feeding assistance intervention.
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