Thegoalofthisstudyistotesttheefficacyofamealtimeintervention(PartnersatMeals)inrespitecare centers(RCCs)thatprovideasocialmodelofcareforpeoplewithdementialivinginthecommunityand supportfortheircaregivers.Largelystaffedbylong-timevolunteers,thesecenterssupportcaregivers?abilityto maintaintheirlovedoneinthehome.Outcomesincludeimprovementsin:a)qualityoflife(QOL)and nutritionaloutcomesforpeoplewithdementia(PWD)andQOLoutcomesforfamilycaregivers(CGs);?b)self- efficacytrainingoutcomesforassessingandmanagingmealsfortheCGsandtheRCCvolunteers;?andc) sustainabilityoutcomesasdeterminedbydirectorsoftheRCCs.TwolargeRCCswithatotalof5sitesofcare insuburbanandruralareasofSCwillbethesitesofthisproject;?and60PWDsand60CGswillberecruited forthiscluster-randomizedtrial,aswellaspotentially60staffandvolunteers.CaregivingforPWDsis increasinglyoccurringinthecommunitybypersonswhoareoftennotpreparedtoassumethisresponsibility. Fortunately,RCCsevolvedasavitalcommunity-basedresourcethatprovidesocialization,meaningful activities,respiteforcaregiversandatleastonemealdaily.MealtimeisaparticularproblemforPWDs becauseasthislife-limitingdiseaseprogresses,theylosethefunctionalabilitytomanagemealsanddisplaya varietyofchallengingbehaviorsallofwhichwilleventuallyaffecttheirabilitytoconsumeadequate caloriesandcontinuethesocialaspectsofmealsthatconnectthemtoothers.AHIPAA-compliant telehealthsystemusingsimple?tablets?willallowCGstocapturebehaviorsandenvironmentalaspectsof mealsinthehomeatthetimebehaviorsoccursothatplansofcarecanbetailoredtoPWDneeds.Usinga train-the-trainermodel,volunteerswillbetaughttoassesstheenvironment(Place),theinteractionsbetween thePWDandothers(People),andtheactionsofthePWD(Person).TheywillthentraintheCGstomake thoseobservationssotheycantailorandchangemealtimesinthehome?thetelehealthcomponent supportsthis.Thusthisprojectcouldbeusedinthecommunityasamodelforbehaviormodificationforother dysfunctionalbehaviorsinthehome.Thisstudyproposestoexaminethefollowingaims:(Primary)Compared toparticipantsin?enhancedusualcare?sites,PWDparticipantsintheinterventionsiteswilldemonstrate improvementinnutritionalstatusanddysfunctionalbehaviors,andQOL;?(Secondary)a)CGswillreport improveQOLandself-efficacyformanagingmeals,anddecreaseddepressionandburden;?c)RCCvolunteers willreportimprovedself-efficacyfortrainingandmanagementoffeedingissues;?andd)Directorswillreport satisfactionwiththeprogramandwillingnesstocontinuetheprogrampost-funding.Additionally, hospitalizationsanddischargesrelatedtonutrition-relatedissuesamongPWDswillbecollectedforfuture work.
Thegoalofthisstudyistotesttheefficacyofamulti-level,mealtimeinterventioninrespitecare centersforpeoplewithdementiaandtheircaregivers.Mealtimesbecomemorechallengingas dementiaprogresseseventuallycausingnutritionalandbehavioralissuesintheaffectedindividuals. Usingatrain-the-trainerprogrambuiltonthePartnersatMealsmodel,volunteersinrespitecenters partnerwithcaregiversanddevelopamealtimeplanthatbuildsonthestrengthsofthepersonwith dementia,anddevelopasupportiveenvironmentforchange.
