Abstract
ObjectivesAn increased amount of functional dependence has been reported among residents living in nursing homes. Among others, feeding dependence is one of the most complex needs to satisfy: behind the attempt to personalise meals with individual preferences and clinical regimens, all residents require help at the same moment and for long periods of time, three or more times a day. With the intent of debating policy implications, the aims of this study were to advance the knowledge in the field of feeding dependence prevalence and predictors in Italy, a country where life expectancy is among the highest in the World. MethodA large retrospective regionally-based study approaching all nursing homes (n = 105) was performed in 2014; all residents (n = 10,900) were eligible and those with a completed assessment recorded in the regional database and aged >65 years (n = 8875) were included. Results1839 residents (20.7%) were in total need of help in feeding on a daily basis. At the multilevel analysis, predictors were moderate/severe dementia (OR 4.044, CI 95% 3.213–5.090); dysphagia (OR 4.003 CI 95% 3.155–5.079); pressure sores (OR 2.317 CI 95% 1.803–2.978); unintentional weigh loss (OR 2.197 CI 95% 1.493–3.233); unsociability (OR 1.561 CI 95% 1.060–2.299); and clinical instability (OR 1.363 CI 95% 1.109–1.677). ConclusionsThe feeding dependence prevalence emerged seem to be unique compared to that documented at the international levels. Modifiable and unmodifiable predictors found require new policies regarding workforce skills-mix and shifts schedules; as well as alliances with families, associations and communities’ stakeholders. According to the complexity of the resident profile emerged, staff education and training is also recommended.
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