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Weight increase in patients with dementia, and alteration in meal routines and meal environment after integrity promoting care
Neurotec Department, Division of Gerontological Caring Science, Karolinska Institutet, Stockholm, Sweden.
Göteborg University, Institute of Neuroscienses, Section of Psychiatry, Mölndal Hospital, Mölndal, Sweden.
Department of Nursing, Umeå University, Umeå , Sweden.
Neurotec Department, Division of Gerontological Caring Science, Karolinska Institutet, Stockholm, Sweden; Centre for Nursing Science, Örebro University Hospital, Örebro, Sweden.
2007 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 5, 987-996 p.Article in journal (Refereed) Published
Abstract [en]

AIMS: To follow weight changes in patients with moderate and severe dementia and analyse how these changes related to biological and psychological parameters after staff education and support in integrity promoting care. A further aim was to describe meal environment and routines relative to the intervention. BACKGROUND: Weight loss in patients with dementia and in particular Alzheimer’s disease (AD) is common. The etiology appears multifactorial with the meal environment and a decreased independence while eating among the factors. METHOD: Over a three-month intervention period, an integrity-promoting care training program was conducted with the staff of a long-term ward. AD patients, 18 from an intervention ward and 15 from a control ward were included and possible effects were evaluated. Weighing was conducted at the start and after completion of the intervention. Weight changes were analyzed in relation to psychological and biochemical parameters. In addition, the staff wrote diaries about e.g. changes made in the environment and in their work.

RESULTS: The most prominent difference observed was weight increases in 13 of 18 patients compared to two of 15 patients in the control ward. No weight changes were related to the type of dementia. The individual weight changes correlated significant to changes in the intellectual functions. Relationships between weight change, increased motor function and increased appetite were non-significant. There was no significant relationship between weight changes and changes in biochemical parameters. According to the staff, increased contact with the patients and a more pleasant atmosphere resulted when the meal environment and routines were changed. RELEVANCE TO CLINICAL PRACTICE: Weight gain in patients with moderate and severe dementia was achieved by adjusting the meal environment to the individual’s needs. Staff education was profitable, as increased competence seemed to promote individually adapted feeding situations. Ensuring good meal situations need to be given high priority.

Place, publisher, year, edition, pages
2007. Vol. 16, no 5, 987-996 p.
Keyword [en]
Dementia, nutrition, staff training intervention, environment, E.H. Erikson’s crises theory
National Category
Geriatrics
Identifiers
URN: urn:nbn:se:hig:diva-2951DOI: 10.1111/j.1365-2702.2006.01780.xISI: 000245988900021PubMedID: 17462050OAI: oai:DiVA.org:hig-2951DiVA: diva2:119613
Available from: 2007-11-27 Created: 2007-11-27 Last updated: 2016-10-18Bibliographically approved

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