Mealtime support for people with dementia in residential care homes: exploring direct care workers’ perceptions, challenges, and training needs

Dementia’s progressive impact on physical and cognitive functions often demands institutionalization, where direct care workers provide essential mealtime support for people with dementia. However, the challenges associated with mealtime assistance are complex, and direct care workers frequently lack specialized training. This study aimed to explore direct care workers’ perceptions and concerns regarding mealtime difficulties of people with dementia and to identify their educational needs for improved performance in helping these people at mealtimes. A qualitative, exploratory study was conducted with 17 direct care workers from three nonprofit residential care settings. Data were collected through semi-structured interviews and analyzed using reflexive, and collaborative thematic analysis, to identify key themes related to direct care workers’ experiences and educational needs. Findings highlighted the significant challenges direct care workers face, such as food refusal and behavioral issues, often intensified by limited time and lack of formal training. Direct care workers expressed a desire for practical, hands-on training tailored to dementia-related mealtime difficulties, emphasizing the importance of learning adaptive techniques to improve care quality. The results underscore the need for targeted training programs that address mealtime challenges in dementia care, considering direct care workers’ current knowledge and learning preferences. Such programs could empower direct care workers, enhancing their skills and confidence, and ultimately benefiting people with dementia by promoting improved mealtime experiences and nutritional outcomes.