A Biopsychosocial Model of Mealtime Management in Persons with Dementia, an Asset-Based Approach to Patient-Centered Care

Abstract

Considering the rapid increase in the population over the age of 65, there is increasing need to consider models of care for persons with dementia (PWD). One common deficit associated with dementia progression is difficulty with successful participation in mealtimes. Difficulty participating in mealtimes in PWD is not the result of one factor, but rather a confluence of biological, psychological, and social characteristics common in dementia. Factors leading to mealtime difficulties for PWD may include changes in cognitive status, altered sensorimotor functioning, and increased reliance on caregiver support. The complex nature of biological, psychological, and social factors leading to mealtime difficulty highlights the need for a pragmatic model that caregivers can utilize to successfully support PWD during mealtimes. Existing models of dementia and mealtime management were reviewed and collated to create a model of mealtime management that considers this complex interplay. The Biopsychosocial Model of Mealtime Management builds on past research around patient-centered care and introduces an asset-based approach to capitalize on a PWD's retained capabilities as opposed to compensating for disabilities associated with dementia. We hope this model will provide a framework for caregivers to understand what factors impact mealtime participation in PWD and provide appropriate means on intervention.

Keywords: dementia; dysphagia; intervention; management; mealtime; model; theory.

Figure 1

The eight interacting dimensions and features of eating and drinking episodes that characterize situational food and beverage consumption among working adults (based on [20]).

Figure 2

Dysphagia management in PWD utilizing a biopsychosocial model as an asset-based approach to patient-centered care.