Managing Xerostomia in Nursing Homes: Pilot Testing of the Sorbet Increases Salivation Intervention

Objective: The purpose of this article was to describe the pilot testing of the Sorbet Increases Salivation (SIS) intervention and describe its impact on salivation and subsequent resident food intake. Methods: Using a repeated treatment design with each elder serving as his or her own control, 12 elders were served 2 ounces of sugar-free lemon-lime sorbet just before the lunch meal for two 3-week periods separated by a 6-week observation (no treatment) period. A plate waste protocol was used to determine actual food intake. Before the initiation of the intervention, salivation was measured (using a Modified Schirmer Test [MST] strip) at baseline and then at 1, 2, and 3 minutes of consuming 2 oz of sugar-free lemon-lime sorbet or 2 oz of water. Summary statistics (means, standard deviations, proportions) were used to describe the study sample. Bivariate statistics determined whether there were significant differences between MST measures or food intake within subjects. Results: Salivation significantly increased after consuming sorbet or water. Most importantly, residents who consumed sorbet salivated more on average in comparison with residents who consumed water. During pilot testing, most residents consumed more food on average during treatment weeks in comparison with observation weeks. Conclusion: The intervention has the potential to increase salivation, decrease complaints of xerostomia, and increase food intake in institutionalized elders with drug-induced xerostomia. The new knowledge gained from this study will lead to further research and testing of the intervention with the long-term goal of transforming the "care-as-usual" approach to meal service in nursing homes. (J Am Med Dir Assoc 2011; 12: 212-216)