Person-Centered and Task-Centered Care and Mealtime Behaviors in Nursing Home Residents with Dementia: Impact on Food Intake

Background and Objectives: Nursing home (NH) staff mealtime care approaches are associated with behaviors of residents with dementia, but their impact on food intake remains unexplored. This study examined the role of staff person-centered and task-centered approaches and resident positive, neutral, and challenging behaviors on food intake. Research Design and Methods: Videotaped mealtime observations (N = 160) involving 36 staff and 27 residents (53 unique staff-resident dyads) in 9 NHs were coded using the refined Cue Utilization and Engagement in Dementia mealtime video-coding scheme. The dependent variable was resident food intake. The independent variables were staff person-centered approaches that support resident abilities, staff-resident (dyadic) interactions, and dining environments, staff task-centered approaches, and resident positive, neutral, and challenging behaviors. Resident challenging behaviors included mealtime functional impairments and resistive behaviors. Linear mixed modeling was used. Moderating effects of staff approaches, food type, and length of dyadic mealtime interactions (ie, video duration) were examined. Results: The relationship between food intake and resident mealtime functional impairments was moderated by food type (p <. 001). The relationship between food intake and resident resistive behaviors was moderated by food type (p =. 002) and staff person-centered verbal approaches (p =. 001). The relationships between food intake and staff person-centered nonverbal approaches (p =. 003) and resident positive/neutral nonverbal behaviors (p =. 004) were moderated by the length of dyadic mealtime interactions. Discussion and Implications: Food intake was associated with staff person-centered approaches and resident positive/neutral and challenging behaviors. Findings emphasize the importance of facilitating positive dyadic interactions using individualized, context-based, multifaceted, person-centered care. Future research on temporal and causal relationships is warranted in larger diverse samples.