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How to Try This: The Edinburgh Feeding Evaluation in Dementia Scale

AJN, American Journal of Nursing: August 2008 - Volume 108 - Issue 8 - p 55
doi: 10.1097/01.NAJ.0000330263.60981.1c
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GENERAL PURPOSE: To describe for registered professional nurses the use and interpretation of the Edinburgh Feeding Evaluation in Dementia scale, used to assess eating and feeding problems in people who have late-stage dementia.

LEARNING OBJECTIVES: After reading this article and taking the test on the next page, you will be able to

  • discuss the importance of assessing eating and feeding in patients who have dementia.
  • describe the appropriate use of the Edinburgh Feeding Evaluation in Dementia scale.
  • outline the development of and recommendations for using the Edinburgh Feeding Evaluation in Dementia scale.


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1. The Edinburgh Feeding Evaluation in Dementia (EdFED) scale is used primarily

a. to categorize overall cognitive decline.

b. as a standardized diagnostic tool.

c. to establish a baseline of behaviors.

d. as a tool for screening for malnutrition.

2. The EdFED scale can be completed in as little as

a. 2 minutes.

b. 5 minutes.

c. 8 minutes.

d. 12 minutes.

3. Which of the following behaviors evaluated with the EdFED scale indicates functional or cognitive decline?

a. turns head away

b. spills food

c. leaves food on plate

d. requires physical help

4. Which of the following behaviors evaluated with the EdFED scale indicates that assistance might be or already is required during a meal?

a. leaves mouth open

b. spits out food

c. refuses to swallow

d. leaves food on plate

5. A patient who needs help with refocusing during meals requires which level of assistance?

a. minimal to no assistance

b. supportive–educative assistance

c. partly compensatory assistance

d. wholly compensatory assistance

6. According to the creator of the EdFED, the scale has demonstrated the same accuracy when measuring behavior through direct observation as when it measures behavior through

a. the caregiver's report.

b. comparisons with baseline.

c. intake and output records.

d. nutrition status parameters.

7. In patients who have dementia, problems with eating and feeding are

a. among the first activities of daily living to be lost.

b. rarely noticeable until the middle stages of dementia.

c. minimal, compared with other profound losses.

d. usually the last activities of daily living to be lost.

8. During the first quarter of 2008, what percentage of the residents of U.S. nursing homes required extensive assistance with eating?

a. 10%

b. 14%

c. 18%

d. 22%

9. In terms of outcomes such as survival, functional ability, and infections, the benefits conferred by tube feeding (in comparison with hand-feeding) are generally

a. positive.

b. detrimental.

c. unmeasurable.

d. of little benefit.

10. It's recommended that, while administering the EdFED scale, the nurse should

a. talk with the patient.

b. talk with the caregiver.

c. observe the entire meal.

d. assist the patient as needed.

11. When the EdFED scale is being used, caregiver input is essential for

a. completing the baseline assessment.

b. keeping the patient cooperative.

c. obtaining consent for administration.

d. reporting the findings of the scale.

12. It's recommended that before adopting the EdFED scale, an institution should first establish a precise definition of

a. assistance.

b. frequency.

c. floor effect.

d. cognition.

13. Of the following, the last level of functioning related to eating is the ability to

a. taste.

b. swallow.

c. hold food in the mouth.

d. open the mouth widely.

14. The EdFED scale has the ability to discriminate between people with late-stage dementia who

a. fed themselves and those who required help.

b. resisted food and those who accepted it.

c. were at risk for aspiration and those who were not at risk.

d. were well nourished and those who were malnourished.

15. The EdFED scale has demonstrated an intrarater reliability of

a. 0.80.

b. 0.85.

c. 0.90.

d. 0.95.

16. Which statement about the EdFED scale is correct?

a. Research to date has been limited to skilled nursing facilities.

b. There are no published reports of the scale's specificity.

c. Sensitivity ranges from 63% to 86%.

d. The reproducibility coefficient is 0.96.

© 2008 Lippincott Williams & Wilkins, Inc.