Perceptions of vitamin D supplementation in long-term care facilities

Abstract

Introduction: Vitamin D deficiency is prevalent among older adults in long-term care (LTC) contributing to increased risk of falls and fractures, and decreased quality of life. The primary factors include limited dietary sources containing vitamin D, poor dietary intake, and low sunlight exposure. Vitamin D supplementation is recommended in LTC; however this practice varies across Canada. Objectives: The objectives of this study were to 1) examine the perceptions of LTC health professionals, staff, and visitors (family and friends) regarding vitamin D supplementation in LTC facilities; and (2) determine what barriers exist in providing vitamin D supplementation to all residents in LTC facilities. Methods: The study was conducted in two phases. Phase 1: Five focus group sessions (9-12 health professionals per group) were conducted in 5 LTC facilities within a Manitoba Regional Health Authority. Each focus group session was audio recorded to assist in generating themes. Phase 2: A self-administered nutrition survey was completed by LTC staff, health professionals, and visitors (family and friends) in all five recruited LTC facilities. Descriptive statistical analyses were conducted. Results: Phase 1: A total of 51 individuals participated (mean age = 46.7 years ± 10.3; female = 90.2%). The majority of participants consisted of Registered Nurses, Health Care Aides, Clinical Dietitians, Pharmacists, Social Workers, Recreation Therapists, and Administrators. Phase 2: A total of 102 individuals participated with an average age of 48.4 ± 13.8 years and were predominately (87.3%) female. Eighty-five percent of participants were LTC health professionals and staff, and 14.7% were visitors (family or friend) of a LTC resident. The results from both phases found that perceptions were positive about providing vitamin D supplementation to residents. Eighty-two percent (phase 1) and 92.2% (phase 2) of participants thought that receiving a supplement would make a difference to the overall health of LTC residents. The major barriers to vitamin D supplementation were: cost (healthcare cost, cost of the supplement, and cost of laboratory tests for serum vitamin D levels), the complexity of residents due to swallowing problems and reluctance with taking medications, polypharmacy, physician resistance, and differences between participants’ knowledge and education on vitamin D. Conclusions: Providing vitamin D supplementation to LTC residents was deemed important and would improve their overall health, but more education is needed to prevent vitamin D deficiency in LTC.