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Article type: Systematic Review
Authors: Chen, Hong-Lia; 1 | Li, Chenga; 1 | Wang, Jinga | Fei, Yanga | Min, Minb | Zhao, Yuea | Shan, En-Fanga | Yin, Yue-Henga | Liu, Chong-Yuanc; * | Li, Xian-Wena; *
Affiliations: [a] School of Nursing, Nanjing Medical University, Nanjing, PR China | [b] Landsea Long-term Care Facility, Nanjing, PR China | [c] Center of Clinical Reproductive Medicine, The NMU First Affiliated Hospital, Nanjing Medical University, Nanjing, PR China
Correspondence: [*] Correspondence to: Xian-Wen Li, Associate Professor of Nursing, School of Nursing, Nanjing Medical University, #101 Longmian Dadao, Jiangning District, Nanjing, Jiangsu Province, 211166, PR China. Tel.: 13770512501; E-mail: [email protected] and Chong-Yuan Liu, Nurse Supervisor, Center of Clinical Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China. E-mail: [email protected].
Note: [1] These authors contributed equally to this work.
Abstract: Background:Feeding and eating disorders related to cognitive and psycho-behavioral symptoms are strongly associated with health status in persons with dementia (PWD). Non-pharmacological interventions have been the priority selection to address this significant issue. However, the direct targets of non-pharmacological interventions are unclear and there is no consistent evidence of recommendations on the intervention of different dementia stages and the settings of intervention practice. Objective:To provide caregivers with a set of self-help non-pharmacological interventions for feeding and eating disorders in PWD. Methods:Based on the process of evidence summary, a systematic literature search was performed on dementia websites and seven databases. Two researchers screened the studies independently and appraise the quality. The evidence was graded by Joanna Briggs Institute Grades of Recommendation. Results:Twenty-eight articles were included. Twenty-three non-pharmacological intervention recommendations were categorized into six themes containing oral nutritional supplementation, assistance with eating and drinking, person-centered mealtime care, environmental modification, education or training, and multi-component intervention. These interventions corresponded to three direct targets including improving engagement, making up for loss ability, and increasing food intake directly. They were applied to different stages of dementia and most interventions were targeted at PWD in long-term care institutions. Conclusion:This article summarized the direct targets and the specific implementation of recommendations at different stages of dementia to provide caregivers with self-help non-pharmacological interventions. The practice of recommendations was more applicable to institutionalized PWD. When applied to PWD at home, caregivers need to identify the specific feeding and eating conditions at different stages and adopted the interventions in conjunction with the wishes of the PWD and professional advice.
Keywords: Alzheimer’s disease, caregivers, dementia, feeding and eating disorders, non-pharmacological intervention
DOI: 10.3233/JAD-221032
Journal: Journal of Alzheimer's Disease, vol. 94, no. 1, pp. 67-88, 2023
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