Ellen S. Schell

Factors Contributing to Dehydration in Nursing Homes: Inadequate Staffing and Lack of Professional Supervision

OBJECTIVE: To investigate the factors that influenced fluid intake among nursing home residents who were not eating well.

The effect of staffing on the quality of care at mealtime

Abstract Inadequate staffing has serious consequences for the nutritional care of nursing home residents. A sufficient number of well-educated and supervised staff members are critical to improving care.

A Prospective Study of the Use of Liquid Oral Dietary Supplements in Nursing Homes1

OBJECTIVE: To investigate the use of liquid oral dietary supplements among nursing home residents who were eating poorly and losing weight.

Staffing and the mealtime experience of nursing home residents on a Special Care Unit

As part of a study that examined the social, cultural, clinical, and environmental factors that influence eating behavior in nursing homes, the effect of staffing on the mealtime experience of residents in a Special Care Unit (SCU) for dementia patients was investigated. An adequate staff to resident ratio, the presence of a knowledgeable and skillful nursing assistant who was an excellent role model, and sufficient supervision positively affected the experience of residents, making lunchtime a pleasant and nourishing event. In the evening, however; overtaxed and poorly supervised aides resorted to strategies that made dinnertime a hurried, unpleasant experience and put residents under duress. A discussion of how to provide extra help at mealtime, improve the education and training of staff, and enhance supervision at mealtime is presented.

The effect of role-taking ability on caregiver-resident mealtime interaction

In this qualitative study of mealtime in a nursing home, data were collected on the verbal and nonverbal interaction between certified nursing assistants (CNAs) and completely eating-dependent residents. Although some caregivers were seen to give care in a creative, empathetic manner, others were task-driven and mechanistic. The difference in caregiving was, in part, accounted for by the degree to which individual caregivers were able to engage in role taking, that is, the ability to see the world from the residents perspective. Recommendations for enhancing role-taking ability include (a) asking caregivers to reflect on their own mealtime experiences, (b) encouraging staff to eat with residents, (c) having staff practice feeding one another, and (d) providing role modeling and supervision by professional nursing staff at mealtime.