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Behavioral Challenges and Adaptive Strategies in Providing Mealtime Care to Residents With Dementia: A Qualitative Study of Nursing Home Clinical and Administrative Staff
Melissa Batchelor‐Murphy, Sana Smaoui, Lígia Passos, Wen Liu. Journal of Applied Gerontology, 2025-10-31
Topic: Risk, prevention and care in population studies
This study examined how nursing home staff adapt to challenging mealtime behaviors in residents with dementia, such as turning away or refusing food. Ten focus groups were conducted with 52 clinical and administrative staff from three southeastern U.S. nursing homes. Transcripts were analyzed using four key codes: feeding behaviors, interventions, training, and communication. Staff described a range of mealtime challenges, including cognitive and functional decline, dysphagia, and elopement. Feeding-related behaviors like refusing to eat reflect the complexity of care required. Staff reported adapting interventions based on residents' abilities, their own interactions, or environmental factors. Most strategies aligned with evidence-based practices, though one novel tactic involved "sprinkling sugar" to stimulate appetite. Findings suggest that reframing feeding behaviors as communication may improve care and reinforces the need for tailored interventions. Differences in staff perspectives emphasize the value of cross-role collaboration in managing mealtime challenges and improving outcomes for residents with dementia.
Key findings
- Findings suggest that reframing feeding behaviors as communication may improve care and reinforces the need for tailored interventions.
Why it matters
This qualitative study examined how nursing home staff adapt to mealtime challenges in residents with dementia, suggesting that reframing feeding behaviors as communication may improve care. It addresses caregiving practices and does not test any treatment, cure or prevention for Alzheimer's disease.
Study details
- Evidence strengthLow
How this study scored 35/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Applied Gerontology) |
| Journal's citation record | 1 / 4 | Journal of Applied Gerontology: journal h-index 92 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Wen Liu: h-index 20 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Iowa: institution h-index 1,080 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41172263) |
| Free to read | 2 / 2 | Free to read |
| Total | 35 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Batchelor‐Murphy, M., Smaoui, S., Passos, L., & Liu, W. (2025). Behavioral Challenges and Adaptive Strategies in Providing Mealtime Care to Residents With Dementia: A Qualitative Study of Nursing Home Clinical and Administrative Staff. Journal of Applied Gerontology. https://doi.org/10.1177/07334648251391869
Vancouver
Batchelor‐Murphy M, Smaoui S, Passos L, Liu W. Behavioral Challenges and Adaptive Strategies in Providing Mealtime Care to Residents With Dementia: A Qualitative Study of Nursing Home Clinical and Administrative Staff. Journal of Applied Gerontology. 2025. doi:10.1177/07334648251391869. PMID: 41172263.
BibTeX
@article{batchelormurphy2025-41172263,
author = {Batchelor‐Murphy, Melissa and Smaoui, Sana and Passos, Lígia and Liu, Wen},
title = {{Behavioral Challenges and Adaptive Strategies in Providing Mealtime Care to Residents With Dementia: A Qualitative Study of Nursing Home Clinical and Administrative Staff}},
journal = {Journal of Applied Gerontology},
year = {2025},
doi = {10.1177/07334648251391869},
pmid = {41172263},
url = {https://doi.org/10.1177/07334648251391869}
}
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