ID: 364 - Meaningful engagement in nutritional understanding (menu) project: developing effective nutrition and hydration action plans for people with dementia in residential aged care

Introduction

Dementia increases malnutrition risk. Malnutrition rates for people living with dementia in residential aged care are high world-wide, often 50% or over. Malnutrition increases ill health and decreases quality of life. This presentation outlines the collaborative development of action plans to improve care for people with dementia in residential aged care in an Australian study: Meaningful Engagement in Nutritional Understanding (MENU).

Methods

The MENU participatory, whole-of-organisation intervention study involves residents, family members and staff collaboratively selecting and implementing customised and best-evidence nutrition care strategies for people living with dementia. Baseline mixed methods data were collected from two participating aged care homes (October 2018 - January 2019). Nutrition knowledge, attitudes and organisational practices were measured via a survey (49 staff & family members), qualitative data from workshops (47 staff, residents & family members), and nutritional screening and ethnographic observations (18 residents living with dementia). Data were analysed using descriptive and thematic approaches and shared with staff, residents and family members at workshops, along with education on best-evidence nutritional care to assist in identification of key intervention areas. Nutrition Champions at each home guided the chosen intervention strategies.

Results

Staff nutrition knowledge was moderate (mean score 6/11 on the survey), with a third having undertaken nutrition education. Observations suggested areas for improvement focused on strategies to increase hydration, maintaining adequate snacks between meals, and enhancing the mealtime environment – including staff and residents eating together and decreasing noise levels in dining rooms. Workshop attendance was challenging as attending to work activities was prioritised over participating in educational research. Despite this, workshop participants, Nutrition Champions, and researchers successfully worked together to consider the data and develop and implement a customised action plan for each care home.

Conclusions

Early findings show the positive impact of customised and evidence-based nutritional care for people with dementia in residential care, supported by tailored nutrition education. Implementing the adaptable and transferable MENU model assisted staff to focus on what worked best for the residents in their care and in their unique setting. This may enhance staff capacity to practice best evidence care, reduce nutrition-related ill health and optimise quality of life for people with dementia in residential aged care.