Feasibility of a Finger Food Menu for Older Adults Post Stroke in Hospital

Many people in hospital after a stroke are at risk of reduced food intake, leading to less effective post-stroke recovery. Finger foods (foods that can be easily transferred from the plate to the mouth without cutlery) have the potential to increase food intake and enable mealtime independence. However, the components of a well-designed trial evaluating a finger food menu in a hospital are unclear, with little published evaluation of how to implement a finger food menu in hospitals. This study aimed to implement a finger food menu and to evaluate the feasibility of using it in a stroke rehabilitation ward.

The feasibility study was a prospective, before-and-after intervention study. Thirty-one hospital inpatients from a stroke ward in a National Health Service hospital in the United Kingdom were included. A finger food menu was offered over two lunchtime meals and compared with the standard lunchtime menu. Feasibility was assessed by evaluating recruitment and retention of patients to the study, feasibility of data collection methods, interrater reliability of plate waste estimations using digital photography and assessing change in food intake. Intervention costs were assessed to support a cost-consequence analysis. Barriers and facilitators to implementation were evaluated through qualitative observations.

Thirty-one participants were recruited (mean age 80, SD 8.5). Retention to the study was low, with 40% of patient participants not completing the study. Attrition was due to participants moving from the study ward. Dietary intake measures were successful via plate waste photography with good interrater reliability κ = 0.709 (95% CI: 0.64-0.77). A cost-consequence analysis identified food costs and staff costs as key to delivering the finger food menu. The ward context and use of an internal facilitator to support the delivery of the intervention are important factors to consider.

Using finger foods in hospitals for older people after stroke is feasible and warrants a future cluster randomised control trial with minor adaptions to the protocol.