This demonstration project found that the reduction of malnutrition and dehydration in nursing homes will require significant paradigm shifts relative to the following: the role of licensed nurses in facilitation of nutrition care; the role of the dietitian in on-going coordination of the personnel and resources necessary for resident feeding assistance; and the role of managers in providing the organizational support necessary for CNAs and other nursing staff to effectively and efficiently provide food and hydration care.

The second year of this project identified best practice methods for accurately determining and tracking food intake, fluid intake, and body weights. Also, a new staff position, the Food and Hydration Aide, was created to promote increased food and fluid intake and to achieve an interdisciplinary team approach for identification of nutrition and hydration problems.