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The association of eating challenges with energy intake is moderated by the mealtime environment in residential care homes

Published online by Cambridge University Press:  09 January 2020

Susan E. Slaughter ,
Jill M. Morrison-Koechl ,
Habib Chaudhury ,
Christina O. Lengyel ,
Natalie Carrier  and
Heather H. Keller
Susan E. Slaughter*
Affiliation:
Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada
Jill M. Morrison-Koechl
Affiliation:
Research Institute on Aging, University of Waterloo, Waterloo, Canada
Habib Chaudhury
Affiliation:
Simon Fraser University, Vancouver, Canada
Christina O. Lengyel
Affiliation:
University of Manitoba, Winnipeg, Canada
Natalie Carrier
Affiliation:
University of Moncton, Moncton, Canada
Heather H. Keller
Affiliation:
Research Institute on Aging, University of Waterloo, Waterloo, Canada
*
Correspondence should be addressed to: Susan E. Slaughter, Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, CanadaT6G 1C9. Phone: 1 780 492 7321; Fax: 1 780 492 2551. E-mail: susan.slaughter@ualberta.ca.
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Abstract

Objectives:

Given the increased risk of malnutrition in residential care homes, we studied how specific aspects of the mealtime environment are associated with residents’ eating challenges and energy intake in general and dementia care units of these homes.

Design:

Cross-sectional study.

Participants:

624 residents and 82 dining rooms.

Setting:

32 residential care homes across Canada.

Measurements:

Eating challenges were measured using the Edinburgh Feeding Evaluation in Dementia Questionnaire (Ed-FED-q). Energy intake was estimated over nine meals. Physical, social, person-centered, functional, and homelike aspects of the mealtime environment were scored using standardized, valid measures. Effects of interactions between dining environment scores and eating challenges on daily energy intake were assessed using linear regression.

Results:

More eating challenges were associated with decreased energy intake on the general (β = −36.5, 95% confidence interval [CI] = −47.8, −25.2) and dementia care units (β = −19.9, 95% CI = −34.6, −5.2). Among residents living on general care units, the functional (β = 48.5, 95% CI = 1.8, 95.2) and physical (β = 56.9, 95% CI = 7.2, 106.7) environment scores were positively and directly associated with energy intake; the social and person-centered aspects of the mealtime environment moderated the relationship between eating challenges and energy intake.

Conclusions:

Resident eating challenges were significantly associated with energy intake on both dementia care and general care units; however on general care units, when adjusting for eating challenges, the functional and physical aspects of the environment also had a direct effect on energy intake. Furthermore, the social and person-centered aspects of the dining environment on general care units moderated the relationship between eating challenges and energy intake. Dementia care unit environments had no measurable effect on the association between resident eating challenges and energy intake.

Keywords

environmentmealtimefood intakeenergy intakeeating challengesdementiaresidential care homeslong-term care
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 7: Issue Theme: Sleep and Sleep Disorders in Older Adults , July 2020 , pp. 863 - 873
Copyright
© International Psychogeriatric Association 2020

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