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A Quality Improvement System to Manage Feeding Assistance Care in Assisted-Living

  • Sandra F. Simmons
    Correspondence
    Address correspondence to Sandra F. Simmons, PhD, Center for Quality Aging, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Suite 350, Nashville, TN 37203.
    Affiliations
    Center for Quality Aging, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN

    Division of Geriatrics, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN

    Geriatric Research, Education, and Clinical Center (GRECC), VA Tennessee Valley Healthcare System, Nashville, TN
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  • Chris S. Coelho
    Affiliations
    Abe's Garden, Alzheimer's and Memory Care Center of Excellence, Nashville, TN
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  • Andrew Sandler
    Affiliations
    Abe's Garden, Alzheimer's and Memory Care Center of Excellence, Nashville, TN
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  • John F. Schnelle
    Affiliations
    Center for Quality Aging, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN

    Division of Geriatrics, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN

    Geriatric Research, Education, and Clinical Center (GRECC), VA Tennessee Valley Healthcare System, Nashville, TN
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Published:February 02, 2018DOI:https://doi.org/10.1016/j.jamda.2017.12.012

      Abstract

      Purpose

      To describe a feasible quality improvement system to manage feeding assistance care processes in an assisted living facility (ALF) that provides dementia care and the use of these data to maintain the quality of daily care provision and prevent unintentional weight loss.

      Design and methods

      Supervisory ALF staff used a standardized observational protocol to assess feeding assistance care quality during and between meals for 12 consecutive months for 53 residents receiving dementia care. Direct care staff received feedback about the quality of assistance and consistency of between-meal snack delivery for residents with low meal intake and/or weight loss.

      Results

      On average, 78.4% of the ALF residents consumed more than one-half of each served meal and/or received staff assistance during meals to promote consumption over the 12 months. An average of 79.7% of the residents were offered snacks between meals twice per day. The prevalence of unintentional weight loss averaged 1.3% across 12 months.

      Implications

      A quality improvement system resulted in sustained levels of mealtime feeding assistance and between-meal snack delivery and a low prevalence of weight loss among ALF residents receiving dementia care. Given that many ALF residents receiving dementia care are likely to be at risk for low oral intake and unintentional weight loss, ALFs should implement a quality improvement system similar to that described in this project, despite the absence of regulations to do so.

      Keywords

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