Daily Archives: 7 March 2024

Facilitating mealtime engagement for older adults with dementia at home: Difficulties and approaches for caregivers

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For many individuals with dementia and their caregivers facilitating home living, navigating mealtime can prove to be a complex task rather than a simple daily routine.

The domestic setting introduces a series of obstacles for the person with dementia and the caregivers involved. These challenges range from confusion and functional impairments associated with dementia to the insufficient support available to friends and family members unexpectedly assuming caregiving responsibilities.

A pioneering study conducted by a team at Ohio State University has established the foundational steps towards developing a future intervention aimed at aiding caregivers in creating a secure and feasible mealtime schedule for dementia patients living at home.

The research highlights the numerous hurdles to patient participation in mealtime activities and draws on interviews with various healthcare professionals to outline methods for improving the dining experience. Recommendations include minimizing distractions, decluttering the eating area, utilizing visual aids, and drawing on resources from community nutrition programs like Meals-on-Wheels.

Lisa Juckett, the study’s lead author and an assistant professor of occupational therapy at The Ohio State University School of Health and Rehabilitation Sciences, emphasizes the importance of simplification in the mealtime environment. According to Juckett, the complexity of eating for individuals with dementia stems from multiple factors beyond mere forgetfulness, underlining the intricate nature of ensuring proper nutrition.

The research, recently published in The Gerontologist Journal, underscores the prevalence of dementia within the United States, with over 80% of those affected living at home. Many of these individuals face difficulty eating or preparing meals independently.

Juckett points out the growing older adult population and the anticipated increase in Alzheimer’s and related dementias, highlighting the strain this will place on the healthcare system and the increased responsibility on unpaid caregivers who desire to keep their loved ones at home.

The study acknowledges the efforts of organizations in offering training and support for home-based dementia care yet recognizes the potential for caregivers to feel too overwhelmed to engage with these resources. By interviewing 20 professionals from various disciplines involved in community-based dementia care, the study identifies key challenges to mealtime participation and recommends practical strategies to address them. These include reducing sensory distractions, decluttering living spaces, providing clear instructions, and optimizing the eating environment to suit the needs of individuals with dementia.

Additionally, the importance of community-based programs like Meals-on-Wheels is highlighted, not only for their direct benefit to those with dementia but also in offering caregivers much-needed support and relief.

The next phase of Juckett’s research involves gathering insights from caregivers and individuals with dementia to refine the intervention strategies further, with the ultimate goal of developing and testing an effective mealtime intervention for home settings.

This effort, supported by the National Institute on Aging’s IMPACT Collaboratory, signifies a significant step towards acknowledging and addressing the complexities of caregiving, particularly around mealtime routines, aiming to reduce the burden on caregivers and enhance the quality of life for individuals living with dementia at home.

The study’s co-authors include notable academics from Ohio State, the University of Wisconsin-Madison, and Brown University, showcasing a collaborative approach to tackling the challenges faced by those affected by dementia and their caregivers.

More information: Lisa A Juckett et al, Supporting mealtime participation among people living with dementia at home: Challenges and strategies for caregivers, The Gerontologist. DOI: 10.1093/geront/gnad167

Journal information: The Gerontologist Provided by Ohio State University

Routine physical activity can decelerate the progression of bone density loss

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A recent investigation highlights the potential benefits of incorporating medium-to-high-intensity impact activities into daily routines to mitigate the effects of ageing on bone density. This study revealed that individuals over 70 who engaged in activities with the intensity of brisk walking or gentle jumping as part of a year-long exercise regimen exhibited a more robust preservation of bone density. Conducted by the University of Jyväskylä in Finland, the research focused on men and women aged 70 to 85 who were previously inactive. While a decrease in bone mineral density at the femoral neck was observed, the overall structural integrity of the bone was either maintained or slightly enhanced for participants who engaged in moderate to high-intensity physical activities compared to those who were less active or whose activities were of lower intensity.

Postdoctoral Researcher Tiina Savikangas emphasized the importance of even short activity durations for skeletal health, noting the study’s attention to the impact forces generated by different activities. It was found that impacts akin to brisk walking were particularly effective in maintaining bone mineral density. The research underscores a common challenge: physical activity levels and bone health tend to decline as individuals age. However, the study suggests that strength training and activities that generate impact, e.g. running and jumping, can counteract bone density loss associated with ageing.

A novel aspect of this research was its examination of everyday physical activities in addition to structured exercise, pointing towards the value of integrating more impactful activities into daily life. Postdoctoral Researcher Tuuli Suominen offered practical advice on increasing high-intensity activities in daily routines, such as taking brisk walks, climbing stairs, and performing heel drops as a non-jumping alternative to create beneficial impacts.

The study highlights the femoral neck’s vulnerability to fractures, especially from falls. It underscores the importance of maintaining bone mineral density and preventing falls to avoid hip fractures. Savikangas and Suominen advocate for increasing daily physical activity in older adults who do not regularly exercise to preserve bone health and prevent fractures by enhancing functional capacity and muscle strength. Improved muscle strength and functional ability reduce the risk of falls and promote more effective bone loading.

This investigation is a segment of the PASSWORD study, executed by the Faculty of Sport and Health Sciences and the Gerontology Research Centre at the University of Jyväskylä, Finland, between 2017 and 2020. It involved 299 less active individuals aged 70 to 85 from Jyväskylä, engaging them in progressive training for muscle strength, endurance, balance, and flexibility. Half the participants received computer-based training to improve information processing skills alongside their physical exercise regimen. Activity levels were quantified with accelerometers, and bone density and structural attributes at the femoral neck were assessed using dual-energy X-ray absorptiometry before and after the year-long exercise program.

More information: T. Savikangas et al, Changes in femoral neck bone mineral density and structural strength during a 12-month multicomponent exercise intervention among older adults – Does accelerometer-measured physical activity matter? Bone. DOI: 10.1016/j.bone.2023.116951

Journal information: Bone Provided by University of Jyväskylä (Jyväskylän yliopisto)