Experimental Comparison of Efficacy for Three Handfeeding Techniques in Dementia.

Journal Article (Journal Article)

BACKGROUND: Nursing home (NH) residents who require assistance during mealtimes are at risk for malnutrition. Supportive handfeeding is recommended, yet there is limited evidence supporting use of a specific handfeeding technique to increase meal intake. OBJECTIVES: To compare efficacy of three handfeeding techniques for assisting NH residents with dementia with meals: Direct Hand (DH), Over Hand (OH), and Under Hand (UH). DESIGN: A prospective pilot study using a within-subjects experimental Latin square design with randomization to one of three handfeeding technique sequences. SETTING AND PARTICIPANTS: 30 residents living with advanced dementia in 11 U.S. NHs. MEASUREMENTS: Time required for assistance; meal intake (% eaten); and feeding behaviors, measured by the Edinburgh Feeding Evaluation in Dementia (EdFED) scale. INTERVENTION: Research Assistants provided feeding assistance for 18 video-recorded meals per resident (N = 540 meals). Residents were assisted with one designated technique for 6 consecutive meals, changing technique every 2 days. RESULTS: Mean time spent providing meal assistance did not differ significantly between techniques. Mean meal intake was greater for DH (67 ± 15.2%) and UH (65 ± 15.0%) with both significantly greater than OH (60 ± 15.1%). Feeding behaviors were more frequent with OH (8.3 ± 1.8%), relative to DH (8.0 ± 1.8) and UH (7.7 ± 1.8). CONCLUSION: All three techniques are time neutral. UH and DH are viable options to increase meal intake among NH residents with advanced dementia and reduce feeding behaviors relative to OH feeding.

Full Text

Duke Authors

Cited Authors

  • Batchelor-Murphy, MK; McConnell, ES; Amella, EJ; Anderson, RA; Bales, CW; Silva, S; Barnes, A; Beck, C; Colon-Emeric, CS

Published Date

  • April 2017

Published In

Volume / Issue

  • 65 / 4

Start / End Page

  • e89 - e94

PubMed ID

  • 28165618

Pubmed Central ID

  • PMC5397360

Electronic International Standard Serial Number (EISSN)

  • 1532-5415

Digital Object Identifier (DOI)

  • 10.1111/jgs.14728


  • eng

Conference Location

  • United States