Mealtimes of the Institutionalized Elderly: A Quality of Life Issue

Abstract

The effect of an individualized occupational therapy programme designed to improve independence in meal management and to enhance the physical and social mealtime environment was examined using a single subject multiple baseline design across four subjects A baseline phase was followed by an intervention phase in which occupational therapy assessment and treatment were introduced. Four subjects of 65 years or older who required verbal guidance and/or physical assistance during mealtimes were assigned to the study group. Mealtime behaviours were videotaped and analyzed by two independent raters. Throughout the project subjects' behaviour in the areas of social interaction, self-feeding responses, verbal prompting and physical assistance required, inappropriate mealtime responses weight change, and caloric intake were monitored using videotape recordings. Data for each subject on each mealtime behaviour were plotted on graphs and analyzed visually for changes in level, trend and variability. The results suggested that an individualized occupational therapy treatment programme promoted greater caloric intake, increased correct self-feeding responses, and decreased inappropriate mealtime behaviour, incorrect self-feeding responses, number of verbal prompts and physical assists, and appropriate weight change. While these results are encouraging, they should be applied cautiously in elderly people in similar situations due to a small sample population and a relatively short intervention period.