Person-centred and task-centred care: Impact on mealtime behaviours in nursing home residents with dementia.

Abstract

Mealtime is a critical daily activity to ensure nutrition, hydration, function and socialisation. Interactions between staff and residents during mealtimes are complex and dynamic processes including verbal and/or nonverbal communication that can be positive/neutral or challenging. This study examined characteristics of and relationships between person-centred and task-centred care and positive/neutral and challenging mealtime behaviours in persons with dementia. This study was a secondary behavioural analyses of videotaped mealtime observations (n= 110) involving 42 unique staff-resident dyads (29 staff and 25 residents with dementia) in nine nursing homes. The refined Cue Utilization and Engagement in Dementia mealtime video-coding scheme was used to code videos during 2019-2020. Dependent variables representing resident mealtime behaviours included positive verbal behaviours, positive/neutral nonverbal behaviours, functional impairments (nonverbal) and resistive behaviours (verbal and nonverbal). Independent variables were staff person-centred and task-centred approaches (verbal and nonverbal). Relationships between resident mealtime behaviours and staff approaches were examined using bivariate analysis and logistic regression. Staff person-centred verbal approaches were associated with resident positive verbal behaviours (OR=1.38, 95% CI=1.09-1.76), functional impairments (OR=0.81, 95% CI=0.66-1.00) and resistive behaviours (OR=1.65, 95% CI=1.18-2.31). Staff person-centred nonverbal approaches were associated with resident functional impairments (OR=1.33, 95% CI=1.02-1.74). Staff task-centred approaches were not associated with resident positive/neutral or challenging mealtime behaviours. This study characterised staff approaches and resident behaviours during mealtime care and provided preliminary support on associations between staff person-centred approaches and resident positive and challenging behaviours. Person-centred mealtime care practice is recommended by focusing on support of common, challenging behaviours and reinforcement of positive behaviours with adequate consideration of individual needs and preferences.