Abstract
There are an increasing number of people with dementia living in their own home for longer, often supported by a family member. The symptoms of dementia can affect an individual's nutritional status, which can lead to a reduced quality of life for the person with dementia and their family members. A scoping review was conducted from July 2016 until September 2016, using a recognised framework, to explore what is currently known, and identify any gaps in the research regarding the nutritional care of people living with dementia at home. This included any interventions that may have been trialled or implemented, and the views of those living with dementia, carers and clinicians. Six electronic databases were searched from inception to July 2016. A review team was involved in screening and data extraction for selected articles. Published qualitative and quantitative studies were included that explored the nutritional care of people living with dementia at home. Methods included data extraction and conventional content analysis. Stakeholders were involved in the development of final categories. Following screening, 61 studies reported in 63 articles were included. Most studies were cross‐sectional (n = 24), cohort (n = 15) or qualitative (n = 9). Only three were randomised controlled trials. Three overarching categories represented the results: Timely identification of nutritional risk and subsequent regular monitoring of nutritional status, multi‐component tailored interventions and the influence of the care‐giving dyad on nutritional status. Many studies identify people living at home with dementia as a vulnerable group prone to malnutrition; however, a lack of interventions exists to address the increased risk. There is a lack of research exploring the role of home care providers and healthcare professionals in the provision of nutritional care. Further research is required to explore how the emotional aspect of the care‐giving dyad influences nutritional care.
Highlights
| METHODOLOGYScoping reviews are useful for gaining a comprehensive overview of the research field of interest
The three randomised controlled trials (RCTs) included in this review focused on the provision of nutritional education to family caregivers and tailored nutritional guidance to people living at home with dementia
Healthcare professionals have an important role in the provision of nutritional care to people living with dementia at home
Summary
Scoping reviews are useful for gaining a comprehensive overview of the research field of interest. A full scoping review protocol was written and agreed by the research team (available from corresponding author on request) Studies included those that featured any intervention, using any study design, with the primary aim of maintaining or improving the nutritional status of individuals (no age restriction, male and females) with dementia or mild cognitive decline, who live at home alone, with family caregivers and/or with home care providers. The overall dietary intake of participants with Alzheimer’s disease in two separate studies was poor compared to cognitively intact age-matched controls, and the authors suggest that this led to a decline in body weight (Guyonnet et al, 1998; Shatenstein, Kergoat, & Reid, 2007) Both studies noted a lack of routine nutritional assessments being conducted at outpatient clinics, a factor re-iterated by many studies included in this scoping review. The main concerns included inadequate and imbalanced food intake of clients, inadequate access to food, and maintaining independence with meal preparation and eating
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