Researchers tested a new program called Partners at Meals (PAM) designed to help family caregivers improve eating habits in people with dementia. The program trained volunteers at care centers to teach caregivers better mealtime strategies through video calls. Over 6 months, people in the PAM program maintained their muscle better and had fewer difficult behaviors at mealtimes compared to those receiving standard care. Caregivers in the PAM group also reported feeling better overall. While the results are promising, the study was relatively small, suggesting more research is needed to confirm these benefits.

The Quick Take

  • What they studied: Whether teaching caregivers special mealtime techniques through video calls could help people with dementia eat better and behave better during meals, while also reducing stress for caregivers.
  • Who participated: 53 pairs of people with mild to moderate dementia (average age 77) and their caregivers (average age 66). They attended respite care centers in the southeastern United States. Half received the new PAM program, and half received regular care.
  • Key finding: People in the PAM program maintained their arm muscle better (gained 1 cm) compared to the control group (lost 0.2 cm), suggesting better nutrition. Caregivers in the PAM group also reported better overall health and quality of life at the end of the study.
  • What it means for you: If you’re caring for someone with dementia, learning specific mealtime strategies through a trained volunteer might help your loved one eat better and reduce stressful mealtime situations. However, this is early-stage research, so talk with your doctor before making major changes to mealtime routines.

The Research Details

This was a cluster randomized controlled trial, which means researchers randomly assigned six respite care centers (places where people with dementia get temporary care) to either receive the new PAM program or continue with regular care. The caregivers and people with dementia who attended these centers were then assigned to whichever program their center offered. The study lasted 6 months and measured changes in weight, eating behaviors, and quality of life for both the people with dementia and their caregivers.

The PAM program used a ’train-the-trainer’ approach, meaning volunteers at the care centers were trained to teach caregivers better mealtime strategies. These volunteers delivered the training through video calls to caregivers in their homes. The program focused on three areas: changing how the person with dementia approaches meals, changing how family members interact during meals, and changing the mealtime environment to make eating easier.

Researchers measured several important outcomes: body weight and muscle size in the arms (to check nutrition), eating difficulties and problem behaviors during meals, quality of life for both the person with dementia and the caregiver, and caregiver stress and depression.

This research approach is important because it tests a program in real-world settings (respite care centers) rather than just in a lab. By training volunteers instead of requiring expensive professional trainers, the program could potentially reach more people. Testing the program over 6 months allows researchers to see if benefits last over time, not just immediately after training.

This study has both strengths and limitations. The strength is that it’s a randomized controlled trial, which is considered strong evidence. However, the sample size is relatively small (only 53 pairs), which means results could be due to chance. The study was conducted in only one region of the United States, so results might not apply everywhere. Some measurements showed no significant differences between groups, suggesting the program’s effects may be modest.

What the Results Show

The study looked at whether people with dementia in the PAM program lost less weight than those in regular care. Interestingly, both groups experienced some weight loss, but the difference between them wasn’t statistically significant (20.8% in PAM group versus 22.7% in control group). However, when researchers looked at arm muscle measurements (a better indicator of nutrition), they found a meaningful difference: the PAM group actually gained muscle (1.0 cm increase) while the control group lost muscle (0.2 cm decrease).

For mealtime behaviors, the PAM group showed improvements in problem behaviors during meals, though the improvement wasn’t statistically significant. The researchers noted that people in the PAM group had fewer difficult mealtime behaviors over the 6-month period.

The most significant finding was for caregiver quality of life. Caregivers in the PAM program reported substantially better overall health and well-being at the end of the study (score of 81.2) compared to caregivers in regular care (score of 68.9). This difference was statistically significant, meaning it’s unlikely to be due to chance.

Interestingly, the study found that the control group consumed more calories at the start of the study, which may have affected the results. Despite this, the PAM group’s better muscle maintenance suggests they were getting adequate nutrition.

Caregiver depression and burden (stress from caregiving) showed slight improvements in the PAM group, but these improvements were not statistically significant. This suggests the program may help with caregiver stress, but more research is needed to confirm this. The quality of life improvements for caregivers were the clearest benefit observed in the study.

Previous research has shown that mealtime difficulties are common in dementia and contribute to poor nutrition and caregiver stress. This study builds on that knowledge by testing whether teaching caregivers specific strategies can help. The train-the-trainer approach is relatively new for dementia care and offers a practical way to deliver interventions. The findings align with other research suggesting that caregiver support programs can improve caregiver well-being, though the effects on the person with dementia’s nutrition are more modest than some might hope.

The study had several important limitations. First, it was relatively small with only 53 participants, making it harder to detect real differences between groups. Second, it was conducted only in the southeastern United States, so results might not apply to other regions or populations. Third, some key measurements (like weight loss and mealtime behaviors) didn’t show significant differences, which could mean the program’s effects are modest or that the study wasn’t large enough to detect them. Fourth, people who started in the PAM group had already lost more weight before the study began, which could have affected results. Finally, the study lasted only 6 months, so we don’t know if benefits continue longer.

The Bottom Line

If you’re a caregiver for someone with dementia, this research suggests that learning specific mealtime strategies through a trained program may help improve your own quality of life and well-being. The evidence is moderate—the program showed clear benefits for caregiver health but more modest effects on the person with dementia’s nutrition. Consider asking your doctor or local dementia support organizations about similar programs in your area. This is not a replacement for medical care but a potential helpful addition to your caregiving toolkit.

Family caregivers of people with mild to moderate dementia should find this research relevant, especially if mealtimes are stressful or if the person with dementia is losing weight. Healthcare providers working with dementia patients may want to consider recommending similar programs. Respite care centers and senior care organizations could use this model to develop their own programs. People with advanced dementia or those in nursing homes may have different needs and should consult their healthcare team.

Based on this study, you might expect to see improvements in caregiver stress and well-being within 6 months of starting the program. Improvements in the person with dementia’s nutrition (measured by muscle maintenance) also appeared within this timeframe. However, weight loss prevention may take longer to become apparent, and individual results will vary.

Want to Apply This Research?

  • Track weekly mealtime stress level (1-10 scale) and note specific difficult behaviors during meals (refusing food, spilling, agitation). Also monitor the person with dementia’s weekly calorie intake estimate and any changes in clothing fit as an indicator of weight/muscle changes.
  • Use the app to set reminders for implementing one specific mealtime strategy each week (such as reducing distractions, using adaptive utensils, or breaking meals into smaller portions). Log which strategies work best for your situation and share results with your healthcare provider.
  • Create a monthly summary tracking: caregiver stress levels, frequency of difficult mealtime behaviors, estimated calorie intake, and caregiver mood/well-being. Compare month-to-month trends to see if the strategies are helping. Share this data with your doctor or dementia care team to adjust approaches as needed.

This research is promising but preliminary. The study was relatively small and conducted in one region, so results may not apply to everyone. This information is not a substitute for professional medical advice. Before making changes to mealtime routines or nutrition plans for someone with dementia, consult with their doctor or a registered dietitian. If you’re experiencing caregiver depression or burnout, reach out to your healthcare provider or a mental health professional. Always discuss any new interventions with your loved one’s healthcare team to ensure they’re appropriate for their specific situation.