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Interventions maintaining eating Independence in nursing home residents: a multicentre qualitative study

Palese, Alvisa; Bressan, Valentina; Kasa, Tea; Meri, Marin; Hayter, Mark; Watson, Roger


Alvisa Palese

Valentina Bressan

Tea Kasa

Marin Meri


BACKGROUND: Despite 32 years of research and 13 reviews published in the field, no intervention can be considered a gold standard for maintaining eating performance among residents with dementia. The study aim was to highlight the interventions derived from tacit knowledge and offered daily in assisting eating by healthcare professionals (HCPs) in nursing homes (NHs). METHOD: A multicentre descriptive qualitative study was performed in 2017. Thirteen NHs admitting residents with moderate/severe functional dependence in eating mainly due to dementia, were approached. A purposeful sample of 54 HCPs involved on a daily basis in assisting residents during mealtime were interviewed in 13 focus groups. Data analysis was conducted via qualitative content analysis. RESULTS: The promotion and maintenance of eating performance for as long as possible is ensured by a set of interventions targeting three levels: (a) environmental, by 'Ritualising the mealtime experience by creating a controlled stimulated environment'; (b) social, by 'Structuring effective mealtime social interactions'; and (c) individual, by 'Individualising eating care' for each resident. CONCLUSIONS: In NHs, the eating decline is juxtaposed with complex interventions regulated on a daily basis and targeting the environment, the social interactions, and the residents' needs. Several interventions that emerged as effective, according to the experience of participants, have never been documented before; while others are in contrast to the evidence documented. This suggests the need for further studies in the field; as no conclusions regarding the best interventions have been established to date.

Journal Article Type Article
Publication Date Nov 27, 2018
Journal BMC Geriatrics
Print ISSN 1471-2318
Electronic ISSN 1471-2318
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 18
Issue 1
Article Number 292
Pages 292
Series ISSN 1471-2318
APA6 Citation Palese, A., Bressan, V., Kasa, T., Meri, M., Hayter, M., & Watson, R. (2018). Interventions maintaining eating Independence in nursing home residents: a multicentre qualitative study. BMC Geriatrics, 18(1), 292.
Keywords Feeding difficulties; Mealtime difficulties; Eating assistance, interventions; Dementia; Elderly; Tacit knowledge; Perceived effectiveness; Nursing home; Qualitative study; Content analysis
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Copyright Statement
© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0International License (, which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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