Clinical Effectiveness

Abstract

Scope: malnutrition among older people in care settings is common and associated with adverse outcomes. Poor standards of mealtime care are reported, with one in five patients not receiving help with eating when required. We assessed the evidence for volunteers improving mealtime care. Search Methods: the literature was searched in August 2008 using databases; MEDLINE®, CINHAL®, BNI and EMBASE. This identified 21 potentially relevant studies. Studies were selected if they described the use of volunteers to assist adults at mealtimes in institutions and the effect this had on outcomes including nutritional intake and satisfaction. Appraisal: seven studies fulfilled the criteria for inclusion. The methodology of 5 of the 7 studies was unclear due to the brevity of the report bringing into question the validity. Results: generally the review suggested the use of volunteers in mealtime care increased satisfaction of patients, relatives, volunteers, and staff concerning meal-time assistance (assessed using methods such as questionnaires and focus groups). One study found that the mean meal intake of 34 patients assisted to eat by a volunteer was increased by 26% in comparison to a matched group assisted by nursing staff. Conclusions: there is some evidence that volunteers can improve mealtime care of patients, however few well designed studies are reported. A detailed evaluation of the use of volunteers to improve the mealtime care in institutions, and any impact on patient health is required.