MEALTIME DIFFICULTIES IN A HOME FOR THE AGED - NOT JUST DYSPHAGIA

A mealtime screening tool was administered to 349 residents of a home for the aged to determine the prevalence of mealtime difficulties incl uding, but not limited to, dysphagia. Mealtime difficulties, as assess ed during a single meal observation of each resident, were documented in 87% of these individuals. Though 68% exhibited signs of dysphagia, 46% had poor oral intake, 35% had positioning problems, and 40% exhibi ted challenging behaviors. An increased prevalence of mealtime difficu lties was related to both the presence and degree of cognitive impairm ent. Oral intake was best among residents with severe cognitive impair ment, many of whom received partial to total feeding assistance. In co ntrast, poor oral intake was associated with mild-moderate cognitive i mpairment, pointing to a need for more aggressive intervention with th is group. The results clearly demonstrate that the prevalence of a wid e range of eating-related problems far exceeds accepted estimates of d ysphagia alone and support a multidisciplinary approach to mealtime in terventions for the institutionalized elderly. Additionally, the magni tude of problems identified has implications for both resource and sta ff-training requirements in long-term care facilities.