Ms Joyce Gibson1, Skye Little1, Ruth Kamau1, Norah Chepkemoi1
1Southern Adelaide Local Health network of SA Health, Adelaide, Australia
Biography:
Joyce is the Senior dietitian in the Repat neuro-behavioural unit, a state-wide specialised service supporting those exhibiting the most severe behavioural and psychological symptoms of dementia. Harnessing her experiences in aged care and Specialist Geriatric Units, she is a passionate advocate for person centred care and service modifications to maximise meal enjoyment in longer stay care facilities. Her research accomplishments include assessing the role of novel hydration assessment devices in residential care (AARIA/Helping Hand Aged Care funded) and developing innovative high protein foods for healthy ageing with Potatoes Australia and the University of Adelaide.
Abstract:
This project examines the impact of mealtime experiences on responsive behaviours in the Repat-Neuro Behavioural Unit (RNBU), which supports those exhibiting the most severe behavioural and psychological symptoms of dementia (BPSD). Furthermore, it underscores the significance of nutritional wellbeing in managing these behaviours revealing a correlation between increased incidents of responsive behaviours coinciding around mealtimes.
Given the diverse, complex nature of this resident cohort, characterised by varying responsiveness to triggers and fluctuating cognitive, sensory, functional and emotional abilities, a multi-disciplinary approach was required. A collaborative team of dietitian, occupational therapist, registered nurses and continuous improvement coach executed a 10-month quality improvement initiative, developing a novel Mealtime Observation Audit Tool and evaluating mealtime experiences and their impact on resident behaviours. Assessments explored environmental factors, resident readiness, care and food service processes. This was supplemented with stakeholder engagement and problem-solving methodologies to identify root causes and devise interventions to minimise mealtime-related responsive behaviours.
Findings indicated inconsistencies in preparing residents, variability in staff skills, frequent adverse sensory stimuli and missed opportunities for social engagement during meals. Improvement initiatives emphasised a multidisciplinary approach in timely responsiveness to complex needs, enhancing staff skills in assistance with meals and exploring allied health roles around mealtimes with advocacy for tailored, flexible interventions in the dining model of care.
Positive outcomes are attributed to the enhanced analysis and innovative problem-solving fostered by the diverse expertise in the team. Improvements highlight the essential role of nutrition and hydration as key non-pharmacological strategies in managing responsive behaviours in dementia care.