High feeding dependence prevalence in residents living in Italian nursing homes requires new policies: findings from a regionally based cross-sectional study

Palese, Alvisa; Grassetti, Luca; Bandera, Davide; Zuttion, Ranieri; Ferrario, Barbara; Ponta, Sandra; Hayter, Mark; Watson, Roger

Abstract

Objectives: An increased amount of functional dependence has been reported among residents living in nursing homes. Among others, feeding dependence is one of the most complex needs to satisfy: behind the attempt to personalise meals with individual preferences and clinical regimens, all residents require help at the same moment and for long periods of time, three or more times a day. With the intent of debating policy implications, the aims of this study were to advance the knowledge in the field of feeding dependence prevalence and predictors in Italy, a country where life expectancy is among the highest in the World.
Method: A large retrospective regionally-based study approaching all nursing homes (n=105) was performed in 2014; all residents (n=10,900) were eligible and those with a completed assessment recorded in the regional database and aged > 65 years (n=8,875) were included.
Results: 1,839 residents (20.7%) were in total need of help in feeding on a daily basis. At the multilevel analysis, predictors were moderate/severe dementia (OR 4.044, CI 95% 3.213–5.090); dysphagia (OR 4.003 CI 95% 3.155–5.079); pressure sores (OR 2.317 CI 95% 1.803–2.978); unintentional weigh loss (OR 2.197 CI 95% 1.493–3.233); unsociability (OR 1.561 CI 95% 1.060–2.299); and clinical instability (OR 1.363 CI 95% 1.109–1.677).
Conclusions: The feeding dependence prevalence emerged seem to be unique compared to that documented at the international levels. Modifiable and unmodifiable predictors found require new policies regarding workforce skills-mix and shifts schedules; as well as alliances with families, associations and communities’ stakeholders. According to the complexity of the resident profile emerged, staff education and training is also recommended.

Citation

Palese, A., Grassetti, L., Bandera, D., Zuttion, R., Ferrario, B., Ponta, S., Hayter, M., & Watson, R. (2018). High feeding dependence prevalence in residents living in Italian nursing homes requires new policies: findings from a regionally based cross-sectional study. Health Policy, 122(3), 301-308. https://doi.org/10.1016/j.healthpol.2018.01.011

• Journal Article Type: Article
• Acceptance Date: Jan 15, 2018
• Online Publication Date: Feb 2, 2018
• Publication Date: 2018-03
• Deposit Date: Jan 15, 2018
• Publicly Available Date: Feb 3, 2019
• Journal: Journal of advanced nursing
• Print ISSN: 0168-8510
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 122
• Issue: 3
• Pages: 301-308
• Series Title: Health Policy
• DOI: https://doi.org/10.1016/j.healthpol.2018.01.011
• Keywords: Feeding dependence; Elderly; Health-care workforce; Nursing home; Policy; Predictors
• Public URL: https://hull-repository.worktribe.com/output/539750
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0168851018300265
• Additional Information: This is the accepted version of an article published in Health Policy, 2018. The published version can be accessed at the DOI link.
• Contract Date: Jan 15, 2018