Mealtime Assistance by Family and Professional Caregivers: An Observational Study of Cognitively Impaired Older Adults in Hospitals and Nursing Homes.

Background: Malnutrition is common among older adults with cognitive impairment and contributes to frailty and poorer health outcomes. Many individuals with dementia require mealtime assistance, yet differences in caregiving practices across hospital and nursing home settings remain underexplored. A...

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Published in:Nursing Reports Vol. 16; no. 1; pp. 6 - 22
Main Authors: Chang, Hui-Chen, Koo, FungKuen, Hui, Juyang, Tang, Hansen, You, Wenpeng
Format: research tables/charts Journal Article
Published: MDPI Jan2026
Online Access:View this record in EBSCOhost
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      dt: Jan2026
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      pub: MDPI
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        atl: Mealtime Assistance by Family and Professional Caregivers: An Observational Study of Cognitively Impaired Older Adults in Hospitals and Nursing Homes.
      aug:
        au:
          Chang, Hui-Chen
          Koo, FungKuen
          Hui, Juyang
          Tang, Hansen
          You, Wenpeng
        affil: School of Nursing and Midwifery, Parramatta South Campus, Western Sydney University, Parramatta, NSW 2151, Australia
      sug:
        subj:
          Cognition Disorders Psychosocial Factors
          Meals
          Eating Behavior In Old Age
          Feeding Methods In Old Age
          Family
          Caregivers
          Hospitals
          Nursing Home Personnel
          Nursing Homes
          Interpersonal Relations
          Nutritional Status
          Motivation
          Human
          Male
          Female
          Cross Sectional Studies
          Nonexperimental Studies
          Descriptive Statistics
          Inpatients
          Data Analysis Software
          kappa Statistic
          Comparative Studies
          Unpaired T-Tests
          Chi Square Test
          Bivariate Statistics
          Motor Skills Disorders
          Distraction
          Aged
          Funding Source
          Questionnaires
          Scales
          Malnutrition Prevention and Control
          Dementia
          Aged: 65+ years
          Male
          Female
      ab: Background: Malnutrition is common among older adults with cognitive impairment and contributes to frailty and poorer health outcomes. Many individuals with dementia require mealtime assistance, yet differences in caregiving practices across hospital and nursing home settings remain underexplored. Aim: The aim of this study was to compare eating encouragement practices, feeding skills, feeding difficulties, and nutritional status between family caregivers in hospitals and professional caregivers in nursing homes. Methods: A cross-sectional observational study was conducted between June 2020 and December 2023 in New South Wales, Australia. The study included 82 older adults (≥65 years) with cognitive impairment: 31 hospital patients supported by family caregivers and 51 nursing home residents supported by assistant nurses. Eating encouragement, feeding skills, and feeding difficulties were assessed using structured observation tools, and nutritional status was evaluated using the Mini Nutritional Assessment–Short Form (MNA-SF). Group differences were analysed using chi-square tests and independent t-tests (p < 0.05). Results: Family caregivers in hospitals demonstrated stronger relational and engagement-based practices, including consistent handwashing (χ2 = 31.945, p < 0.001), encouraging self-feeding (χ2 = 21.678, p < 0.001), verbal cueing (χ2 = 12.083, p = 0.002), touch prompting (χ2 = 51.817, p < 0.001), and sitting face to face (χ2 = 38.697, p < 0.001). Nursing home caregivers showed more advanced technical skills, such as task simplification (χ2 = 54.135, p < 0.001), mirroring (χ2 = 78.456, p < 0.001), hand-over-hand guidance (χ2 = 73.076, p < 0.001), mouth- and lip-opening techniques (both χ2 = 81.000, p < 0.001), and stronger choking management (p < 0.001). Feeding difficulties also differed: refusal behaviours were more common in nursing homes, while distraction and oral–motor issues were more frequent in hospitals. Overall, nursing home residents had significantly poorer nutritional status (t = −12.592, p < 0.001). Conclusions: Family caregivers provide stronger relational support, whereas professional caregivers demonstrate superior technical competence. Integrating these complementary strengths may enhance mealtime care and reduce malnutrition among cognitively impaired older adults.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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