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Verbal communication and behaviour during meals in five institutionalized patients with Alzheimer-type dementia
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0000-0001-5994-4012
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.ORCID iD: 0000-0002-8114-7615
1988 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 13, no 5, 571-578 p.Article in journal (Refereed) Published
Abstract [en]

Five institutionalized patients with Alzheimer-type dementia were observed (video-recorded) during meals. The aim was to assess their meal behaviour and social interaction. The results showed that when the patients ate without the participation of staff, the two least demented patients became 'caregivers' in the group and helped the three most demented patients to eat. When two mental nurses joined the group, the patients dropped their roles as helpers. The conversation in the group could be characterized as incomplete, with short sentences and a lot of breaks. Sixty-three per cent of all comprehensible utterances concerned food and eating and almost all conversation concerned the present.

Place, publisher, year, edition, pages
John Wiley & Sons, 1988. Vol. 13, no 5, 571-578 p.
Keyword [en]
Alzheimer-type dementia, verbal communication, eating behavior
National Category
Nursing Psychiatry
Identifiers
URN: urn:nbn:se:umu:diva-36388DOI: 10.1111/j.1365-2648.1988.tb01450.xPubMedID: 3225360OAI: oai:DiVA.org:umu-36388DiVA: diva2:354028
Available from: 2010-09-29 Created: 2010-09-29 Last updated: 2017-12-12
In thesis
1. Aspects of institutional care of patients with dementia
Open this publication in new window or tab >>Aspects of institutional care of patients with dementia
1986 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of the present study was to investigate all long-term institutions in the county of Västerbotten, Northern Sweden, to give a detailed description of the institutionalized population with respect to motor functions, vision, hearing, speech, ADL-functions, prevalence of psychiatric symptoms and behavioral disturbances, staff work load, use of psychoactive drugs and prevalence of dementia. Another aim was to select some specific 'problem areas' in the nursing care of demented patients for further descriptive and interventional studies. For this reason, morning care procedure (hygiene, dressing), meal behavior (eating, communication), nutrition, constipation and relocation between institutions were selected.

The results of the study have been reported in six papers summarized below:

I.The study has shown that the proportion of demented patients is increasing in longterm institutions in Sweden. Furthermore, demented patients were shown to be more impaired in all rated functioning abilities and exhibited more psychiatric symptoms and behavioral symptoms. A high proportion of the demented probands were also prescribed psychoactive drugs, i.e. neuroleptics.

II. Five patients with Alzheimer-type dementia were monitored during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients were able to manage morning care independently, but there was a wide variation in their highest level of performance.

III. Five patients with Alzheimer-type dementia were observed (video taped) during their meals in a changed meal milieu and with new meal routines. When the patients ate without staff participation, the two least demented patients became 'caregivers'. When two mental nurses joined the group, first in civil clothes and then in white uniforms, the patients dropped their roles as helpers. The patients were able to compose complete meals in 0-79 per cent of the meals. The conversation during the meals could be characterized as incomplete, with short sentences and a lot of breaks. Sixty-three per cent of all utterances were about food and eating and almost all conversation concerned the present time.

IV. Thirty-three psychogeriatric patients, with severe constipation were given a high- bran bread instead of their accustomed laxatives. During the high-bran treatment period, the number of bowel evacuations and the volume of faeces increased. The total laxative consumption decreased by 93 per cent.

V. Nutritional status and dietary intake were studied in a sample of severely demented, institutionalized patients. Energy and /or protein malnutrition was found in 50 per cent of the patients. The mean energy intake was 2059 kcal. Malnourished patients had had four times as many infectious periods during their hospital stay as patients without malnutrition. Thirty-nine of 44 patients lost weight during their hospital stay.

VI. Thirty-three psychogeriatric patients were followed for 36 weeks after relocation from a mental hospital to two newly built nursing homes. An intensive pre-relocation program was performed. No negative effects of the relocation were found. On the contrary, the relocated group improved their ADL-functions after the transfer.

Based upon the above cited studies, a model for nursing care of demented patients is presented.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 1986. 45 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 181
Keyword
Dementia, institutional care, ADL, constipation, conversation, dietary intake, morning, care, relocation
National Category
Nursing Geriatrics Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-100563 (URN)91-7174-270-0 (ISBN)
Public defence
1986-12-19, Hörsal A, Samhällsvetarhuset, Umeå universitet, Umeå, 09:00
Supervisors
Projects
digitalisering@umu
Note

S. 1-45: sammanfattning, s. 46-192: 6 uppsatser

Available from: 2015-03-09 Created: 2015-03-04 Last updated: 2015-04-10Bibliographically approved

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