Impact of Cognition and Handfeeding Assistance on Nutritional Intake for Nursing Home Residents

J Nutr Gerontol Geriatr. 2019 Jul-Sep;38(3):262-276. doi: 10.1080/21551197.2019.1617221. Epub 2019 May 24.


In nursing homes (NHs), residents are at risk for malnutrition and weight loss. The purpose of this secondary data analysis was to examine the impact of resident cognitive status and level of feeding assistance provided by NH staff on resident's daily nutritional intake and body weight. As part of a large, multisite clinical trial (N = 786), residents with and without dementia were examined according to level of feeding assistance required during mealtimes (independent, set-up only, needs help eating) over a 21-day period. Outcomes analyzed were percent of meal intake by meal type (breakfast, lunch, dinner) and overall daily intake (meals + snacks/supplements). Residents with dementia who required meal set-up assistance had significantly lower meal intake for all three meals. Residents without dementia requiring meal set-up assistance experienced significantly lower intake for breakfast and dinner, but not lunch. When snacks and supplements were offered between meals, residents with dementia consumed approximately 163 additional calories/day, and residents without dementia consumed approximately 156 additional calories/day. This study adds new evidence that residents at greatest risk for low intake are those who are only provided set-up assistance for meals and/or have cognitive impairment.

Keywords: Dementia; TURN study; feeding assistance; handfeeding; nursing home; nursing home resident; nutritional risk; weight loss.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Canada
  • Cognition*
  • Dementia / epidemiology
  • Dementia / nursing*
  • Eating
  • Energy Intake*
  • Feeding Behavior
  • Feeding Methods / nursing*
  • Feeding Methods / statistics & numerical data
  • Humans
  • Malnutrition / epidemiology
  • Meals
  • Nursing Homes / statistics & numerical data*
  • United States
  • Weight Loss