{"id":5559,"date":"2017-06-02T09:25:21","date_gmt":"2017-06-02T07:25:21","guid":{"rendered":"https:\/\/www.nutrisens.com\/vitalites\/mealtimes-for-alzheimers-patients-hand-positioning-all-important\/"},"modified":"2022-04-12T21:41:02","modified_gmt":"2022-04-12T19:41:02","slug":"mealtimes-for-alzheimers-patients-hand-positioning-all-important","status":"publish","type":"vitalites","link":"https:\/\/www.nutrisens.com\/en\/vitalites\/mealtimes-for-alzheimers-patients-hand-positioning-all-important\/","title":{"rendered":"Mealtimes for Alzheimer\u2019s patients: hand positioning all-important"},"content":{"rendered":"<div class=\"desc-p\">\n<p>\n\t\tThe position of the carer\u2019s hand when assisting at mealtimes makes a significant difference to the patient\u2019s food intake. \u00a0<\/p>\n<p>\n\t\tNursing home residents who require assistance during mealtimes are at risk of malnutrition. Patients suffering from dementia, in particular, may refuse to eat or drink because they have problems swallowing or suffer from apraxia. A team of carers from the nationally ranked geriatric division of Duke University (North Carolina) compared three techniques for caring for patients with dementia. Their findings were published in the Journal of the American Geriatrics Society.\u00a0<\/p>\n<h3>\n\t\tDementia requires a three-pronged approach\u00a0<\/h3>\n<p>\n\t\tAccording to the study, achieving successful mealtimes for a resident with dementia requires a unique set of skills:<\/p>\n<ol>\n<li>\n\t\t\tmanaging dysphagia and risk of aspiration<\/li>\n<li>\n\t\t\tinterpreting and managing attitudes (e.g., turning head away, clamping mouth shut)\u00a0<\/li>\n<li>\n\t\t\tpromoting independence in eating while providing adequate supportive handfeeding assistance to maintain nutritional intake.\u00a0<\/li>\n<\/ol>\n<p>\n\t\tThe recommendations evoke two main handfeeding techniques:\u00a0<\/p>\n<ul>\n<li>\n\t\t\tDirect Hand: the carer holds the fork or spoon and feeds the patient;<br \/>\n\t\t\t\u00a0<\/li>\n<li>\n\t\t\tOver Hand: the carer puts their hand over the patient\u2019s, who holds the fork, and guides their movements.\u00a0<\/li>\n<\/ul>\n<p>\n\t\tIn a third technique, the carer holds their hand under the patient\u2019s hand to guide it.\u00a0<br \/>\n\t\tThe team of carers based in North Carolina compared the efficacy of the three techniques on assisting 30 Alzheimer\u2019s sufferers (average age 88.5, 90% women) in 11 nursing homes. Each technique was tested over six consecutive meals (2 days). Duration of assistance, food intake and behaviour were recorded according to the Edinburgh Feeding Evaluation in Dementia scale. A total of 540 meals were filmed (18 per patient) and analysed.<\/p>\n<h3>\n\t\tPlacing the hand under the patient&#8217;s has advantages<\/h3>\n<\/div>\n<p>\n\t<img decoding=\"async\" alt=\"\" src=\"\/sites\/default\/files\/300x250_0.jpg\" style=\"width: 300px; height: 250px; float: left;\" \/>The duration of assistance was the same whatever the technique (41\u201345 minutes). Food intake was best with the Direct Hand technique (67 \u00b1 15.2%) and Under Hand (65 \u00b1 15.0) compared to 60 \u00b1 15.1% for the Over Hand technique. Refusal attitudes were more frequent with the Over Hand technique (8.3 \u00b1 1.8%) compared to the Direct Hand technique (8.0 \u00b11.8%) and the Under Hand technique (7.7 \u00b1 1.8%). The authors of the study recommend that the technique should be chosen according to the patient\u2019s energy levels, physical abilities and preference. A different technique may be used on different days or for specific meals. In general, the Direct Hand or Under Hand methods are considered most effective. Of course, none of the techniques resolves the problem of the lack of time available for carers to spend on mealtime assistance.<\/p>\n<p>\n\t<em>Batchelor-Murphy, M. K., McConnell, E. S., Amella, E. J., Anderson, R. A., Bales, C. W., Silva, S., Barnes, A., Beck, C. and Colon-Emeric, C. S. (2017), Experimental Comparison of Efficacy for Three Handfeeding Techniques in Dementia. Journal of the American Geriatrics Society, 65: e89\u2013e94. doi: 10.1111\/jgs.14728<\/em><\/p>\n<p>\n\t<em><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28165618\u00a0\" target=\"_blank\" rel=\"noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28165618\u00a0<\/a><\/em><br \/>\n\t\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The position of the carer\u2019s hand when assisting at mealtimes makes a significant difference to the patient\u2019s food intake. \u00a0 Nursing home residents who require assistance during mealtimes are at risk of malnutrition. Patients suffering from dementia, in particular, may refuse to eat or drink because they have problems swallowing or suffer from apraxia. A [&hellip;]<\/p>\n","protected":false},"featured_media":1814,"template":"","thematique_blog":[24],"tags_blog":[78],"class_list":["post-5559","vitalites","type-vitalites","status-publish","has-post-thumbnail","hentry","thematique_blog-alimentation-adaptee","tags_blog-alzheimer"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.nutrisens.com\/en\/wp-json\/wp\/v2\/vitalites\/5559","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nutrisens.com\/en\/wp-json\/wp\/v2\/vitalites"}],"about":[{"href":"https:\/\/www.nutrisens.com\/en\/wp-json\/wp\/v2\/types\/vitalites"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.nutrisens.com\/en\/wp-json\/wp\/v2\/media\/1814"}],"wp:attachment":[{"href":"https:\/\/www.nutrisens.com\/en\/wp-json\/wp\/v2\/media?parent=5559"}],"wp:term":[{"taxonomy":"thematique_blog","embeddable":true,"href":"https:\/\/www.nutrisens.com\/en\/wp-json\/wp\/v2\/thematique_blog?post=5559"},{"taxonomy":"tags_blog","embeddable":true,"href":"https:\/\/www.nutrisens.com\/en\/wp-json\/wp\/v2\/tags_blog?post=5559"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}