Delivering good nutritional care for people with dementia

By the time someone with dementia moves into a care home, they may already be experiencing significant weight loss and other nutrition-related problems. This may trigger further physical and mental deterioration, which means that supporting people living with dementia to eat and drink well, can be quite a challenge for busy care and nursing staff. 

With funding from The Burdett Trust for Nursing, researchers from Bournemouth University (Professor Jane Murphy and Joanne Holmes) have been exploring this issue to understand how to improve the delivery of nutritional care for people with dementia living in care homes.  As a result of their research project, key themes were identified that have informed the development of a new conceptual model to guide improvements for nutritional care in care homes1. The seven identified domain areas were person-centred nutritional care (the overarching theme); availability of food and drink; tools, resources and environment; relationship to others when eating and drinking; participation in activities; consistency of care and provision of information.  

We recognised there was a need for research in this area as there were no evidence-based approaches or training programmes to provide staff with information about good nutrition. 

People with dementia may need much longer to eat due to poor co-ordination or becoming tired more easily. Others may be losing their appetites or facing difficulties with chewing and swallowing. As dementia progresses, many people become less able to sense thirst so may be unaware they are dehydrated. 

We worked together with local council, care homes and charities to explore the issue and have now developed a workbook and training film packed full of ideas for staff to try out that can be used at any time.  It has been a great experience working in partnership with all these organisations as we’ve been able to gather different perspectives and ideas.  It has helped us to create a much richer resource than we could have produced on our own.
Through this evidence-informed model, the team has since implemented new education and training tools (workbook, film and leaflet) for caregivers to improve their knowledge, understanding and delivery of nutrition in dementia. A new guide designed for all care staff will also be available via the website soon.

The tools help to explain the importance of good nutrition and provide staff with lots of practical tips and ideas to try out.  These include:

Keeping people interested in food by getting them involved in food preparation activities, including growing their own fruit and vegetables; eating meals together with carers, which allows people to copy actions if they’re struggling to remember how to eat; adapting the physical environment to create an improved dining experience using colours, smells and lighting used at meal times.

The resources have been used by health and social care staff in the UK and have already helped people with dementia to eat and drink well. Further evaluation work has shown that this is transforming practice and the wellbeing of people, with dementia with staff implementing more person-centred approaches to nutrition-related care and importantly, it is leading to weight gain in people who were at risk of, or were losing weight.

All the resources are all freely available from the website www.bournemouth.ac.uk/nutrition-dementia. 

Jane Murphy
is Professor of Nutrition, a Registered Nutritionist and Dietitian and co-leads the Ageing and Dementia Research Centre at Bournemouth University