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Evaluating a brief intervention for mealtime difficulty on older adults with dementia

Rehman, Salma; Likupe, Gloria; McFarland, Agi; Watson, Roger


Salma Rehman

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Dr Gloria Likupe
Lecturer and Researcher in Healthcare/ Chairperson of School Athena Swan group

Agi McFarland

Roger Watson


Aims and objective: To test a spaced retrieval intervention using spaced retrieval to alleviate mealtime difficulties in older people with dementia. Design: A single-case study design. Setting: Nursing Homes in North Central England, United Kingdom. Participants: Older people with Alzheimer’s disease. Methods: A single-case study using an ABA design was used. Data were collected using the Edinburgh Feeding Evaluation in Dementia scale, Mini Nutritional Assessment, and Body Mass Index before intervention, postintervention and following 3 months of postintervention. Realist evaluation was used to identify for which participants the intervention was effective, and an economic evaluation was also carried out. Finding: Of 15 participants who entered the study, eight completed all phases of the study. A mean 104.4 h were needed to deliver the intervention. The number of sessions required ranged from 90–222. The length of time each participant retained information (for all sessions) ranged from 13–28 min. Participants had most difficulty with: “putting food into mouth and chewing it”; “realizing it was mealtime”; and “eating a whole meal continuously.” A reduction in the difficulty with mealtimes occurred between phase A1–A2 for most participants. Six participants maintained this in phase A3. Similar patterns were evident for nutritional scores. For most participants, the effect size of the intervention was moderate or large. Conclusions: Spaced retrieval is useful in reducing mealtime difficulties in older participants with dementia. While the results of this study are promising, further large and multicentre trials are needed to explore the effectiveness of the intervention in diverse populations.


Rehman, S., Likupe, G., McFarland, A., & Watson, R. (2022). Evaluating a brief intervention for mealtime difficulty on older adults with dementia. Nursing Open,

Journal Article Type Article
Acceptance Date Jul 5, 2022
Online Publication Date Jul 20, 2022
Publication Date 2022
Deposit Date Aug 15, 2022
Publicly Available Date Aug 16, 2022
Journal Nursing Open
Electronic ISSN 2054-1058
Publisher Wiley
Peer Reviewed Peer Reviewed
Keywords Dementia; Mealtimes; Nutrition; Older people; Single-case study; Spaced retrieval
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Copyright Statement
© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.<br /> <br /> This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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