The Duke University School of Nursing is excited to announce the Center of Geriatric Nursing Excellence Student Scholar Program. Students are invited to participate in the scholarly work of the Center affiliated faculty to deepen their awareness and commitment to nursing science in the field of gerontological nursing. Listed below are the faculty projects with the student experiences.
Comparison of Hand Feeding for Persons with Dementia in the Nursing Home
For this project, the student scholars worked with project director Melissa Batchelor-Murphy, PhD, RN, to deliver a hand feeding intervention aimed to increase meal intake and improve nutrition for older adults with dementia living in the nursing home. The scholars also participated in video coding sessions, and will be able to carry the skills learned into their own practice and future educational endeavors. Read their personal statements below.
Mary Scott Powell
After seeing a flyer about the hand feeding research project, I knew that I had to participate. During the summer of 2012, I was hired as a nursing assistant at an assisted living that specialized in memory care. During my work experience, I witnessed the effects of dementia and how it interferes with a person’s ability to function. I met incredibly intelligent people, including lawyers, professors, journalists, etc. who could no longer eat, brush their teeth, walk, or do any of their old routines. However, despite the effects of dementia, these people still pushed on, stayed positive, and gave wise advice. While it may have been my job to take care of the residents, in reality, they helped me by teaching me life lessons on strength, humility, and compassion. In addition, they inspired me to pursue my dream of becoming a nurse. Since these people gave so much to me, I saw participating in this research study as a way to give back.
This research study has affected my life in various ways. Prior to this study, I had never even heard of alternative hand-feeding techniques. Now, I have successfully begun using all three techniques in my practice, and I have also been able to teach them to other nursing colleagues. In addition, I learned that everyone, even if they have the same disease, is very different. For example, the residents in this study would communicate that they were full verbally while others did so non-verbally, and it was important to pay close attention to the person’s needs. Because of this newfound knowledge, I make a point to assess a patient’s both verbal and nonverbal cues. I have found this to be a helpful communication skill for all patients, not just for those who have dementia. Lastly and most importantly, this research study further fueled my passion for serving others, especially those in the geriatric population. My ultimate goal for my life and career is to give more than I take. My hope is that my contribution in this research study and my career as a nurse will give back to those in the geriatric populations who have and who will continue to touch my life.
Kim Ray
One of the main reasons why I wanted to participate in this research study is to learn how to better communicate with patients with dementia during meal time. I had an experience during my medical-surgery clinical in which I had difficulty feeding my client who was post-rectal surgery and also suffering from dementia. Because the client’s speech was poor, I was already challenged in assessing the client’s needs but it was more demanding to encourage him to consume any foods or fluids. I felt incredible empathy for the client as I was aware of the impact of nutrition in helping individuals recover from surgical procedures. I remember leaving the unit that day thinking, what else I could have done to create a better feeding experience for that client.
Fortunately, I was able to become a research assistant for the study and begin learning about the three different hand-feeding techniques. From just the exposure to these essential variables, I was much more knowledgeable about how to approach patients with dementia during feeding time. Because of this experience, I feel much more confident in becoming creative with helping patients with dementia enjoy their meal experience during my nursing career.
Nicholas D'Amico
My involvement with Dr. Batchelor-Murphy’s research regarding hand-feeding techniques included participating in feeding one person with dementia of the course of a few weeks. I fed and documented their behavioral response to the new methods. I recorded food amounts, participant affect and physical behaviors. I also participated in next phase of the research with included video-coding the behaviors from four participants with dementia. This experience has helped congeal my future goals with my nursing career. My plan is to become a Psychiatric Gerontological Nurse Practitioner, in which I can help guide seniors into the next stage of their life with confidence and well being. I saw this study as a wonderful opportunity to see people with mental illness living life. I was able to use therapies such as the Positive Person Approach while feeding this participant. Through this study I have been able to experience first-hand the huge impact that therapeutic touch and encouragement has on another human. I hope to learn even more as my years in my nursing education progress. I want to thank Dr. Batchelor-Murphy, Duke University School of Nursing, and the National Hartford Center for Gerontological Nursing for this wonderful opportunity. I strongly recommend this experience to those who wish to purse a similar experience.
Stephanie Dibenedetto
Through the support of the National Hartford Center for Gerontological Nursing, Dr. Melissa Batchelor-Murphy was able to conduct this study allowing different hand-feeding techniques to be studied for use with patients with dementia. After volunteering in several nursing homes and completing several clinical rotations for the University of North Carolina Wilmington’s School of Nursing in the same type of setting, I developed a special interest in patients with dementia from a medical perspective and as well as within my heart. When I first heard of this research study, I immediately looked up the development of these particular hand-feeding techniques. Based on this knowledge, I felt as though this unique experience would allow for improvements in not only the care of patients with dementia but also with the patient’s health and physical ability. I have been able to apply these hand-feeding techniques in my current position as a nursing assistant in a local nursing care facility. Before beginning this study, I was unaware of the importance of research in the nursing field. In order to implement any kind of change in the care of patients, there must be research by nurses to provide the evidence base. By participating in this research, I have gained knowledge on this process and hope to continue being involved with nursing research as I move forward in my nursing career.
Vanessa Sillaman
As a Certified Nursing Assistant (CNA) who has previously worked in a skilled nursing facility, I have witnessed first-hand how important nutrition is to the aging population. In this field of work I have also learned some of the struggles which occur during mealtimes. When I first learned about this particular research project, I knew instantly that I wanted to be a part of it. Through this study I was able to learn appropriate hand feeding techniques, which increased my knowledge and skills of how to properly handle some of the difficulties which occur during mealtime. This newly acquired knowledge and skill has allowed me to provide quality mealtime experience to persons with dementia, which I firmly believe will continue to benefit the aging population.
Participating in this experience has contributed to my future educational and career goals by influencing me to further my education beyond becoming a nurse and to pursue geriatric nursing as a career. This research project has allowed me to apply knowledge which I have learned in a practical way that I will further use in my career in the healthcare field. I chose to pursue a geriatric healthcare career because elderly patient care is a challenge; it requires thinking beyond the normal and taking into consideration all the biological, psychological, and social changes that are associated with aging. This research project has taught me how to think beyond the normal, to be empathetic by placing myself in the shoes of an older adult with dementia, and to be as understanding and compassionate as possible.
Loni Tyndall
Before I began working as a research assistant for Dr. Melissa Batchelor-Murphy, I would not have guessed that the highlight of my summer would be watching my patient eat some of her meals independently, and helping her with some, smiling with accomplishment nearly the entire time. I was intrigued when I heard of the opportunity to take part in a research study working with Duke University School of Nursing while in Wilmington, to find the best hand-feeding technique for dementia patients. During past experiences volunteering with Alzheimer patients, I had noticed the feeding techniques, or lack thereof, employed by the CNAs. Believing adequate nutritional intake to be an important area of adult care that needed to be improved, I was happy to work as a research assistant. With my three patients, I saw firsthand how mealtime can be difficult and trying for both dementia patients and their caregivers. I expected the internship to be a learning experience, but I could not have known how much it would teach me about interactions with persons with dementia and the importance of patience and positivity in healthcare. I am grateful for the experience and I look forward to continued work in the health care field during nursing school and my future career as a nurse.
Morgan Fisher
As a nursing student at the University of North Carolina Wilmington’s School of Nursing, I was honored to participate in Dr. Batchelor-Murphy’s hand-feeding research. I think this study will really improve the care of older adults struggling with dementia. My involvement with this study has inspired me to continue working within the field of nursing research. Within my lifetime, I look forward to seeing the improvement of care methods for older adults with dementia implemented as a result of this study.
Brooke Perrigo
When provided the opportunity to participate in this research project, I was immediately interested. As a current student in UNC Wilmington’s School of Nursing, I understood that having the opportunity to work with Duke School of Nursing as a research assistant was a fantastic chance for me to learn hands-on how research plays a practical role in nursing and also collaborate with a well renowned research program outside of UNC Wilmington. Through this research project I have gained a plethora of knowledge regarding the research process and how to safely implement a research intervention that is ethical, organized, informed and free from potentiating physical or psychological harm. This research project has also allowed me to understand the intricate attention to detail essential while implementing and analyzing research interventions.
As I enter my senior year in my nursing school, I have realized that I have an escalating interest in advancing my education and plan to pursue a Doctoral degree in Nursing Practice and likely specialize in geriatrics. When I first started nursing school I would have never thought that I would have such a growing passion for the geriatric population. I believe my passion for geriatrics has developed from a combination of working as a CNA in a nursing home and completing my geriatric nursing course, but being able to assist in this study has convinced me that geriatrics will be my ultimate calling in my advanced nursing practice. This research study has also helped me to realize that I really do have a passion for applying research into practice while questioning and evaluating current standards of care, thereby affirming my goal to obtain a DNP and contribute to practical nursing research through implementing evidence-based advanced nursing practices. I will be forever grateful for the experiences and personal connections this research project has offered.