Dr. Keller’s interest in nutrition and dementia first developed when she worked as a clinical dietitian in chronic care. Undernutrition is common in long-term care facilities and with chronic care patients, partly because of difficulties in self-feeding and environmental processes that influence food intake. Much of Dr. Keller’s research in dementia has been conducted in institutions. Recently, it was demonstrated (Keller et al, 2003) that undernutrition could be improved even in the most vulnerable seniors experiencing cognitive impairment in long-term care. Rather than focusing on a single approach such as a liquid supplement, Dr. Keller has focused her interventions on the whole system, including: dietitian expertise, food system and menu, and the eating environment. She is especially interested in the psychosocial, emotional, and physical environment and how these influence food intake in older adults with dementia.

Professor Keller has recently turned her attention to seniors with dementia and their families living in the community. Eating Together is a longitudinal qualitative project that investigates the perceptions of families around mealtimes when a member is experiencing dementia. Challenges and strategies that families have developed that meet the changing needs of seniors with dementia were also identified in Phase I. As a result of this research, we have come to understand that mealtimes mirror the way the family is living with dementia. The way in which families manage mealtime changes influences ‘being connected’ and ‘honouring identity’, and thus the dementia journey. Families’ experiences range from existing with dementia to living life to the fullest. As a result of Phase I, several fact sheets focused on eating issues have been created to assist those living with dementia and their care partners.

Phase II of the Eating Together was conducted from 2008-11. In addition to continued data collection from Phase I families, families who had recently transitioned into longterm care were recruited. Research was also conducted on tablemates in retirement homes to determine how to improve this key social relationship. A Mealtime Social Interaction Longterm Care (MSILTC) measure has been developed and tested to ensure reliability. Work continues on developing and testing interventions, including educational and mentoring programs for staff, family care partner training, and measurement of social interaction during mealtimes.

Factsheets

 

Research Articles

Genoe, R., Dupuis, S., Keller HH, Schindel Martin, L, Edward H.G, Cassaloto, C. (accepted Jan, 2009). Honouring identity through mealtimes in the context of dementia. Journal of Aging Studies.

Keller HH, Schindel Martin, L., Dupuis, S., Genoe, R., Edward, H.G., Cassaloto, C. (accepted August 2008). Mealtimes and being connected in the dementia context. Dementia.

 

Research Briefs

Mealtimes & Connecting

Meal rounds help identify issues

Preventing weight loss in long term care

Better Nutrition Choices Needed for Dementia Care in Our Communities!

Keller HH, Smith D, Kasdorf C, Dupuis S, Schindel Martin L, Edward HG, Cook C, Genoe R. (2008). Nutrition education needs and resources for dementia care in the community. American Journal of Alzheimers Disease and Related Dementias, Feb/March, 13-22.

Keller HH, Edward HG, Cook C. (Dec 2006/ Jan2007). Mealtime experiences of families with dementia. Am J Alzheimers Disease Other Dementias, 21(6), 431-438.

Keller HH, Gibbs-Ward A, Randall Simpson JA, Bocock MA, Dimou E. (2006). Meal rounds: a simple and effective way to improve the quality of nutrition services. J Am Med Directors Assoc 7(1), 40-45.

Gibbs-Ward A, Keller H.H. (2005) Mealtimes As Active Processes in Long-Term Care Facilities. Can J Diet Res 66(1), 5-11. Abstract

Keller, HH. (2005) Weight loss in dementia can be prevented. In: Research and Practice in Alzheimer’s Disease Volume 10, Vellas, B. Winblad, B., Grudman, M., Fitten, L.J., Feldman, H., and Giacobini, E. (eds). Serdi Publisher, Paris. pg 147-151.

Keller H.H. Identifying nutrition problems in senior patients. (2004) Geriatrics and Aging, 7(4), 62-65.

Keller H.H. (2004). Éviter la perte de pids au cours du syndrome démentiel (Weight loss in dementia can be prevented). Age and Nutrition (Reviews), 15(3), 162-164.

Keller H.H., Gibbs A, Boudreau L, Goy R, Brown H, Pattillo M. (2003). Prevention of weight loss in dementia with comprehensive nutritional treatment. J Am Geriatrics Soc 51, 945-951. Abstract

Keller H.H., Hirdes J.P. (2000). Using the Minimum Data Set to determine the prevalence of nutrition problems in an Ontario population of chronic care patients. Can J Diet Pract Res; 61(4), 165-171. Abstract

Keller, H.H. (1995). Weight gain impacts morbidity and mortality in institutionalized older persons. J Am Geriatrics Soc 43, 165-169. Abstract

Keller, H.H. (1994). Practical guidelines for staff management of undernutrition in a long-term care population. Nursing Home Medicine, 2(7), 40-49.

Keller, H.H. (1993). Malnutrition in institutionalized elderly: how much and why? J Am Geriatrics Soc 41, 1212-1218.