Comparison of Hand Feeding Techniques for Persons With Dementia

Duke University30 enrolled

Overview

The purpose of this study is to test three hand feeding techniques that can be used to provide feeding assistance to persons with dementia - direct hand feeding, hand-over-hand feeding, and hand-under-hand feeding.

Proposed Aim 1: To collect pilot data related to using three hand feeding techniques for feeding persons with dementia (PWD) in the nursing home (NH) setting: (1) direct hand feeding; (2) hand-over-hand feeding; and, (3) hand-under-hand feeding. Primary outcomes are impact on frequency of aversive feeding behaviors, meal intake, and time spent assisting with feeding. Proposed Aim 2: Evaluate implementation of the hand feeding intervention for larger randomized study of feeding techniques. Aim 2a: Conduct a process evaluation for method of recruiting, screening, and obtaining informed consent of legally authorized representatives (LARs)/ assent of PWD. Aim 2b: Establish fidelity to treatment for all three hand feeding interventions.

Study Type

INTERVENTIONAL

Allocation

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Enrollment

Conditions

Dementia

Interventions

Hand feeding techniquesBEHAVIORAL

Direct hand feeding technique: When the feeding assistant holds the object (e.g., fork, spoon, cup) intended to provide food or fluids to the PWD without any active involvement on the part of the PWD. Hand-over-hand feeding technique: Occurs when the PWD is holding the object (e.g., fork, spoon, cup) in an attempt to feed/ drink for themselves. If the PWD has trouble with this activity, the feeding assistant puts his or her hand over the hand of the PWD, in an effort to guide/ support/ assist the PWD with the activity. Hand-under-hand feeding technique: Occurs when the feeding assistant holds the object (e.g., fork, spoon, cup) and places the PWD hand over the top of their hand; therefore, the feeding assistants hand is under the hand of the PWD in a more supportive position.

Eligibility

Sex: ALLMin age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Resident of nursing home 6 weeks prior to intervention delivery * 60+ years old * Have a legally authorized representative to provide informed consent * medical diagnosis of dementia * required extensive assistance to total dependence for feeding * Brief Interview for Mental Status (BIMS) score of 0-12 Exclusion Criteria: * Positive diagnosis of Human Immunodeficiency Virus (HIV), Parkinson's, and/or Traumatic Brain Injury * Any swallowing disorder * Presence of feeding tube that is sole source for meal delivery * Significant auditory or visual impairment

Locations (11)

Rex Apex

Apex, North Carolina, United States

Carolina Meadows

Chapel Hill, North Carolina, United States

Carver Living Center

Durham, North Carolina, United States

Outcomes

Primary Outcomes

Change in frequency of aversive feeding behaviors

Changes in behaviors of person with dementia being assisted with 3 meals daily over 6 days

Time frame: Day 6

Changes in time spent providing feeding assistance

Changes in time spent providing feeding assistance to a person with dementia being assisted with 3 meals daily over 6 days

Time frame: Day 6

Changes in meal intake

Changes in meal intake for a person with dementia being assisted with 3 meals daily over 6 days

Time frame: Day 6

Secondary Outcomes

Functional ability and feeding behaviors exhibited by person with dementia

Coding of video recorded meals from Outcomes 1-3

Time frame: Day 6

Characterize feeding assistant responses to functional ability and feeding behaviors

Coding of video recorded meals from Outcomes 1-3

Time frame: 6 days

Develop decision-making algorithm of adaptive approaches used by feeding assistant

Coding of video recorded meals from Outcomes 1-3

Time frame: 6 days

Data from ClinicalTrials.gov

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