The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65781

Peter S. Reed, MPH, Department of Health Behavior and Health Education, School of Public Health, Univeristy of North Carolina, 500 Umstead Dr., #102C, Chapel Hill, NC 27516, 919-824-3994, preed@email.unc.edu, Sheryl I. Zimmerman, PhD, Program on Aging, Disability, and Long-Term Care, Sheps Center for Health Services Research, University of North Carolina, 725 Airport Road, CB# 7590, Chapel Hill, NC 27599-7590, and Philip Sloane, MD, MPH, Family Medicine, University of North Carolina, CB #7585, Chapel Hill, NC 27599.

Cognitively impaired residents of nursing homes and assisted living facilities need and deserve high quality care in many aspects of their lives to create a positive and meaningful existence. Quality care is particularly important during meals to ensure adequate food and fluid intake, due to an inability of many residents to independently attend to their own consumption needs. Using a newly developed instrument, the Midday Meal Observation (MMO), administered to residents with dementia (n=413) living in both nursing homes and assisted living facilities (n=44), this presentation will identify contributors to successful meal outcomes. First it will assess resident need and dependency factors, such as level of cognitive impairment, dysphagia, apraxia and positioning problems as determinants of meal outcomes. Second it will consider the mediating and moderating effects of environmental and staff assistance characteristics on the relationship between resident need and meal outcomes. Correlational and multivariate regression analyses elucidate associations between resident need, environmental characteristics and staff assistance, as they relate to unmet need in food and fluid intake. Analyses account for both main and interaction effects of these determinants in illustrating their associations. Results show optimal outcomes when providing a level of assistance commensurate with resident need within an environment conducive to successful meals. Understanding the factors associated with successful meal outcomes helps to clarify points of intervention to improve resident food and fluid intake, as well as overall experience during mealtime in long-term care facilities.

Learning Objectives:

• At the conclusion of this session, paticipants will be able to:
• 1)Articulate resident, staff, and environmental characteristics that serve as determinants of food and fluid intake among cognitively impaired residents of long-term care.
• 2)Discuss the interactions of these determinants in creating the overal resident experience during mealtime in long-term care.
• 3)Identify implications for developing interventions to improve meal outcomes in long-term care.

Keywords: Nutrition, Long-Term Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.