Improving food intake in nursing home residents with feeding assistance: Astaffing analysis

Background. Recommendations have been made to increase the number of nursin g home (NH) staff available to provide feeding assistance during mealtime. There are. however, no specific data related to two critical variables nece ssary to estimate mealtime staffing needs: (1) How many residents are respo nsive to feeding assistance? (2) How much staff time is required to provide feeding assistance to these residents? The purpose of this study was to co llect preliminary data relevant to these two issues. Methods. Seventy-four residents in three NHs received a 2-day. or six-meal. trial of one-on-one feeding assistance. Total percentage (0% to 100%) of f ood and fluid consumed during mealtime was estimated across 3 days during u sual NH care and 2 days during the intervention. The amount of time that st aff spent providing assistance and type of assistance (i.e,, frequency of v erbal and physical prompts) was measured under each condition. Results. One half (50%) of the participants significantly increased their o ral food and fluid intake during mealtime. The intervention required signif icantly more staff time to implement (average of 38 minutes per resident/me al vs 9 minutes rendered by NH staff). Conclusions. The time required to implement the feeding assistance interven tion greatly exceeded the time the nursing staff spent assisting residents in usual mealtime care conditions. These data suggest that it will almost c ertainly be necessary to both increase staffing levels and to organize staf f better to produce higher quality feeding assistance during mealtimes.