None listed
Conditions
Brief summary
Research suggests that the majority of Australians with dementia in residential aged care are malnourished or at risk of malnourishment. This project seeks to change this unacceptable situation by trialling a practical multi-component nutrition support intervention (MENU: Meaningful Engagement in Nutritional Understanding) that arose from suggestions from staff in a Tasmanian aged care home on how to improve care and support of people with dementia. The project will trial MENU in two Wicking-partner aged care facilities. The impact of MENU on raising staff awareness of best nutrition care and support for residents with dementia and reducing malnutrition prevalence will be evaluated. There are two specific objectives: 1. raise awareness (knowledge and practice change) among care facility staff/care volunteers/family of best nutrition care for residents with dementia; 2. reduce residents’ malnutrition risk. The project findings, outputs and the MENU approach will be disseminated across Tasmania.
Interventions
The intervention will facilitate Meaningful Engagement in Nutritional Understanding (MENU):
M Meaningful: Eating is an enjoyable social activity, not a task to be completed
E Engagement: Residents, family and staff in all positions at all levels collaborate to select
best-evidence care approaches tailored to their care home’s needs and preferences
N Nutritional: Systematic nutrition assessment is essential to monitor general health and
prevent infections that result in hospitalisation, and compr
The intervention will facilitate Meaningful Engagement in Nutritional Understanding (MENU): M Meaningful: Eating is an enjoyable social activity, not a task to be completed E Engagement: Residents, family and staff in all positions at all levels collaborate to select best-evidence care approaches tailored to their care home’s needs and preferences N Nutritional: Systematic nutrition assessment is essential to monitor general health and prevent infections that result in hospitalisation, and compromise brain and internal organ function U Understanding: Residents participate actively in their care and staff appreciate how daily acts to support nutrition can make a vast difference and improve key function and health indicators. MENU involves a 10-month education-oriented intervention which incorporates a 4-month period of practice change implementation. Implementing MENU will involve residents, family, staff and care volunteers from two Tasmanian aged care homes working together to: 1. Workshop and select a number of ideas for change to nutrition care that are supported by evidence and suited to their care home (examples in List below), 2. Participate in tailored education facilitated by staff members who volunteer to work together as Nutrition Champions to drive change, including mentoring and coaching staff (3/home), 3. Work with Nutrition Champions to implement these changes over four months, and 4. Assist with developing a short video to benefit care staff to distribute across Tasmania. LIST. BEST-EVIDENCE NUTRITION CARE EXAMPLES Staff/care volunteers/family sharing meals with residents Family/buffet-style meals (e.g. residents choose food on table) Reminiscence cooking sessions Appropriate placement and prompts to eat/drink Alternative meal choices (e.g. if less than half consumed) Eating environment ambience (e.g. music) Face-to-face workshops in each aged care home will run from 60-90 minutes and will involve the following key components: Workshop 1 • Staff, care volunteers, family complete Nutritional Knowledge Questionnaire • Discuss range of evidence-based strategies to facilitate nutritional health • Identify Nutrition Champions for each care home Workshop 2 • Discuss baseline findings • Work collaboratively to select best evidence practices that suit each care home • Education on best evidence care practices (e.g. 15 minute presentations each from dietitian and principal investigator; role-playing; discussion, partly facilitated by Nutrition Champions) • Identify educational support materials for staff/family (e.g. posters, lanyard prompt cards) Workshop 3 • Discuss progress & problem-solve any barriers, as will be mid-intervention Workshop 4 • Re-administer Nutritional Knowledge Questionnaire • Feedback and discussion on the intervention Additional education of Nutrition Champions will involve a 90 minute face-to-face session, including a 30 minute presentation by a dietitian, 15 minute presentation by principal investigator, role-play, and discussion. To monitor adherence to the 4-month period of practice change implementation, Nutrition Champions will conduct monthly ethnographic observation audits to assess care practices
Sponsors
University of Tasmania
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Educational / counselling / training
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Participants will be recruited from two aged care facilities where they will reside, work or volunteer, or be a family member of a resident. The criteria for residents’ inclusion in the study are: 1. Resident in the aged care facility for over four weeks; 2. Has symptoms of cognitive impairment or dementia (e.g. over 9/21 on Psychogeriatric Assessment Scale–Cognitive (moderate-severe impairment)). The criteria for aged care workers, care volunteers and family members are: 1. Has paid or voluntary employment at, or has a family member living in, one of the participating aged care homes; 2. Aged 18 year or over.
Exclusion criteria
People highly dependent on medical care or, in the opinion of nursing staff, at end-of-life.
Outcome results
None listed