BARRIERS AND FACILITATORS TO RECEIVING ADEQUATE NUTRITION IN LONG-TERM CARE RESIDENTS LIVING WITH MODERATE TO SEVERE DEMENTIA.

Abstract

Dementia is a condition that affects the cognitive and functional abilities of older adults, often leading to the need for long-term care (LTC) homes. Malnutrition resulting from difficulties in eating practices caused by dementia can lead to negative consequences, such as higher hospitalization rates, lower quality of life, and more co-morbidities. Previous studies have identified barriers and facilitators to eating performances for LTC residents with dementia from the perspectives of staff, but the current study aimed to explore these factors from the perspectives of LTC residents with moderate to severe dementia, family members, and staff. Participants were recruited from two LTC homes owned by Northwood in Halifax, Nova Scotia, and data were collected through interviews with 7 family members, 4 residents with moderate to severe dementia, and 4 staff members, including a registered nurse, licensed nurse practitioner, continuing care assistant, and registered dietitian. Data triangulation was applied by conducting interviews, mealtime observations, and pre- and post-consumption measurements of food intake with residents. The study analyzed data using deductive and inductive content analysis, guided by the socio-ecological model. Results showed that barriers and facilitators at the intrapersonal, interpersonal, environmental, and policy-related levels. Barriers included factors such as high variability within residents, cognitive and physical challenges, staff's lack of training and preparation, competing work demands, time pressures, and environmental factors. Understanding the barriers and facilitators is crucial for developing feasible, person-centered, evidence-driven interventions that address challenges and enhance the facilitators in LTC homes.