Cultural perspectives in feeding difficulty in Taiwanese elderly with dementia.

OBJECTIVE To investigate factors related to feeding difficulty that is shown in the interaction between nursing assistants and elderly residents with dementia. METHODS Forty-eight residents and 31 nursing assistants were observed during meal times in a congregate dining room of a Taiwanese nursing home specializing in dementia care. Residents' eating behaviors, the dining environment, interactions between the nursing assistant and the residents, and feeding strategies used by nursing assistants were observed. Nutritional data for residents were collected from medical charts. The EdFED Scale #2 and interviews of nursing assistants provided information about feeding difficulty. Interviews also provided data on strategies used to address feeding difficulties. FINDINGS The most frequent feeding difficulty was refusal to eat (37.5%). The strategies used by nursing assistants were limited. Nursing assistants stated they needed more training to address feeding difficulty in residents with dementia. CONCLUSIONS Future research should be focused on the interface between the residents and nursing assistants who must identify various feeding difficulties and select appropriate interventions. CLINICAL RELEVANCE Results might provide information that can be used to develop effective interventions and promote high-quality mealtime care in patients with dementia.