Feeding Assistance Needs of Long-Stay Nursing Home Residents and Staff Time to Provide Care

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 54; no. 6; pp. 919 - 924
• Main Authors: Simmons, Sandra F., Schnelle, John F.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-06-2006; Blackwell
• Subjects: Aged, 80 and over; Biological and medical sciences; Dependency; Eating; feeding assistance; Feeding difficulties; Feeding Methods - nursing; Female; Follow-Up Studies; General aspects; Health participants; Homes for the Aged; Humans; Male; Medical sciences; Nursing Assessment; Nursing Homes; Nursing Staff - standards; Nutrition Assessment; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality Assurance, Health Care; Staff; staffing requirements; Time management; Human; Long stay; Nursing home for the aged; Health staff; Health care staff; Time; Care; Feeding; Requirement; Need; Gerontology; Number of employees; Resident; staffing requirements; feeding assistance; Homes for the aged; Staff recruitment; Nursing home; Elderly; nursing homes; Geriatrics
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2006.00812.x

OBJECTIVES: To describe the staff time requirements to provide feeding assistance to nursing home residents who require three different types of assistance to improve oral food and fluid intake (social stimulation, verbal cuing, or both; physical guidance; or full physical assistance) and to determine whether physically dependent residents require more staff time, as defined in the national Resource Utilization Group System (RUGS) used for reimbursement.
DESIGN: Descriptive.
SETTING: Six skilled nursing homes.
PARTICIPANTS: Ninety‐one long‐stay residents with low oral intake who responded to improved feeding assistance.
MEASURMENTS: Research staff conducted direct observations of usual nursing home care for 2 consecutive days (total of six meals) to measure oral food and fluid consumption (total percentage eaten) and staff time spent providing assistance (minutes and seconds). Research staff then implemented a standardized graduated‐assistance protocol on 2 separate days (total of six meals) that enhanced residents' oral food and fluid intake.
RESULTS: Staff time to provide feeding assistance that improved food and fluid consumption was comparable across different levels of eating dependency. Across all levels, residents required an average of 35 to 40 minutes of staff time per meal; thus, residents who needed only supervision and verbal cuing required just as much time as those who were physically dependent on staff for eating.
CONCLUSION: The current RUGS system used for reimbursement likely underestimates the staff time required to provide feeding assistance care that improves oral intake.