Current Activities in Long Term Care
By Kate Lynch, Editor  www.activities4elders.com/
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Current Activities
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A bi-monthly magazine that
provides useful activities,
calendars, therapeutic
activities and programs,
feature stories, specialized
activities for Alzheimer's
patients and
other disease conditions,
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Email: klynch@cfu.net
Feeding program improves food intake, new
research shows

The program, a joint effort of several US research centers supported by the National
Institute on Aging, the National Institute of Health and the University of California at Los
Angeles, was developed specifically for elders at risk of weight loss, and led to
significant weight gain in just six months.

The program involves providing either one-to-one mealtime assistance or between-
meal snacks, twice a day for five days a week.

It was tested on 35 nursing home residents for six months.

At the end of the trial, changes in weight, body mass index (BMI) and daily caloric intake
observed in participants were compared with changes reported for 34 matched
controls, who received standard care.

Poor food intake, weight loss and low EMI are indicative of undernutrition and increase
mortality risk.  In the study, participants in the program not only significantly increased
their daily caloric intake and BMI, they also gained an average of four pounds more than
controls.

Importantly, while elders on the program maintained or increased their weight, those
receiving standard care lost weight.

During the trial, feeding assistance was provided at breakfast and lunch, and consisted
of
•        properly positioning the elder before the meal;
•        allowing elders to choose where and what they wanted to eat;
•        offering alternatives, if elders didn’t like the food in the tray; and
•        providing verbal prompts, encouragement and praise to enhance the elders’ self-
feeding ability.

Between-meal snacks were also offered twice a day (at l0 a.m. and 2 p.m.). Elders
were given plenty to choose from, while considering any dietary restriction they might
have.

Snacks and drinks were brought to the residents with a cart. They included:
•        fruit juices and yogurt;
•        ice cream, fresh fruit, puddings, and pastries; and
•        cheese or peanut butter with crackers.

“This study is the first controlled intervention trial to evaluate the effects of sustained
feeding assistance on nursing home residents’ oral food and fluid intake, BMI, and
weight,” writes Dr. Sandra Simmons, of Vanderbilt University, Nashville, Tennessee,
and colleagues in the Journal of the American Geriatric Society.

“The results show that optimal feeding assistance provided during or between regularly
scheduled meals, twice per day, 5 days per week, for 2t weeks has a significant effect
on all three outcome measures.”
The researchers say standardized protocols have been developed to help nursing
home staff identify residents who could benefit from feeding assistance during meals
or between-meal snacks.
   These protocols are available online at:
http://borun.medsch.ucla.edu,“Weight Loss Prevention” (module), and
http://www.cms.internetstreaming.com, “How to Enhance the Quality of Dining
Assistance in Nursing Homes” (webcast).

The study’s findings appear in the August 2008 issue of the journal.

A doll for your Alzheimer’s elders

Findings from a small study presented in July at the Annual Conference for Psychology
Specialists Working with Older People, part of the British Psychological Society at the
University of Essex, Colchester, United Kingdom, confirm that dolls can be a valuable
help in the care of persons with Alzheimer’s disease.

Clinical pathologist Dr. Ian James, of Newcastle General Hospital, and coworkers,
studied 14 Alzheimer’s residents over a period of three months. Of these, 13 chose a
doll and one chose a teddy bear.

Consistent with previous research, James’ team found that having a doll or a teddy
bear improved communication and reduced withdrawal, agitation and distress.

“Using toys in therapy offers patients ways to either ‘interact with’ or ‘take care for’
something that they seem to have sense of ownership and responsibility for,” states the
society.

“Examples of their use include reminiscence scenarios where life-like dolls have been
introduced to residents and used to stimulate memories of an earlier rewarding life
role, such as that of a parent.” While the benefits of the use of dolls in dementia care
has been looked at before, says James, this study looked at the impact over a long
period of time.

“The findings will, we hope, help advise other clinical teams in their use of this
technique,” he said.