Table 4 Promising interventions that are presently unproven, but that warrant early reassessment in high quality and well powered RCTsa
Aim | Potential interventions (presently unproven) which warrant early reassessment |
|---|---|
Increase weight and/or BMI | o Oral Nutrition Supplements (ONS) (Figs. 2 and 3) o ONS, gratin diet for those with swallowing problems, plus exercise and oral care (Beck) [31] o Dysphagia diet (reformed minced and pureed foods and thickened fluids) for those with swallowing problems (Germain) [57] o Meal replacement with commercial lyophilised supplement (Salas-Salvado) [61] o Multifactorial intervention including enhanced menu, individualised food service, more dietetic time, increased nutritional awareness and communication (Keller) [63] o Individual mealtime assistance (Wong) [67] o Shared mealtime with staff (Charras) [69] |
Improve hydration | o No particularly useful interventions were noted, but cervical spine manipulation appeared to increase dysphagia limit for those with swallowing problems (Bautmans) [56] |
Support meaningful engagement with food and/or drink | o Eating with carers (Charras) [69] o Family style meals for people with dementia, enhanced further by staff training (Altus) [68] o Facilitated breakfast club with supported involvement in preparing, conversing, eating and clearing up (Santo Pietro) [71] |
Improve quality of life | o Reminiscence cooking sessions (Huang 2009) [70] |
Support eating independence | o No particularly useful interventions assessed |
Improve quantity, quality or adequacy of food or fluid intake | o Combination of ONS, gratin diet, exercise and oral care (Beck) [32] o Finger food provision (Soltesz) [60] o High carbohydrate dinners (Young) [62] o Meal time or between meal feeding assistance, or individual mealtime assistance (Simmons 2008, Wong 2008) [66, 67] o Dysphagia diet (reformed minced and pureed foods and thickened fluids) for those with swallowing problems (Germain) [57] |