Table 1.

Coding Scheme for Measuring Mealtime Interactions and Behavioral Symptoms

Caregiver Codes		Resident Codes
Person Centered Behaviorsa			Behavioral Symptomsb
Verbal Behavior	Non-Verbal Behavior		Behavior Group
■Greeting ■Asking resident for help/cooperation ■Giving choice ■Assessing comfort or condition ■Orientation ■Empathy ■Showing approval ■Showing interest ■Back-channel response ■Positive voice quality	■Resident-directed eye gaze ■Affirmative nodding ■Appropriate use of affectionate touch ■Assessing comfort ■Adjusting to resident’s pace ■Proximity ■Positive gestures/facial expressions	Aberrant Vocalizations	■Minimally disruptive: low volume/louder than conversational; redirectable ■Loud, disruptive: moderately-severely disruptive; screaming/yelling
		Motor Agitation	■Minimal: pacing/moving about; mildly increased rate of movement; redirectable ■Intense-rapid: moderately-severely disruptive; not redirectable
Task-Centered Behaviorsa		Aggressiveness	■Verbal threats ■Threatening gestures ■Physical toward property ■Physical toward self/others
Verbal Behaviors	Non-Verbal Behaviors
■Verbal controlling ■Interrupting/changing topic ■Controlling voice quality	■Ignoring ■Physically controlling ■Inappropriate touch ■Outpacing
Other Caregiver Codes		Resisting Care	■Procrastination/avoidance ■Verbal/gesture of refusal ■Pushing away to avoid tasks ■Striking out at caregiver
■Lack of interactionc

^aItems from the Person-Centered Behavior Inventory (PCBI) and Task-Centered Behavior Inventory (TCBI) were used to measure the person-centeredness of caregiver actions during mealtimes. Both scales have demonstrated inter-observer reliabilities averaging.82 (Coleman & Medvene, 2012; Hannah Lann-Wolcott et al., 2011) Outpacing was added using definitions provided in the Dementia Care Mapping tool, which has demonstrated test-retest reliability ratings >0.8. (D. J. Brooker & Surr, 2006; Fossey, Lee, & Ballard, 2002)

^bBehavioral Symptoms were measured using the Pittsburgh Agitation Scale (PAS), which has demonstrated inter-observer reliabilities averaging 0.92 in NHs (J. Rosen et al., 1994; Jules Rosen et al., 1995). The intensity rating of 0 to 4 was modified for each behavior group to a rating of 1 to 2.

^cLack of interaction was coded when there was no interaction for more than 2 minutes (verbal or non-verbal) when the caregiver was in close proximity to the resident during the meal or for more than 3 minutes if the caregiver was interacting with another staff member without engaging the resident.