{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T15:19:03Z","timestamp":1778167143542,"version":"3.51.4"},"reference-count":46,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["60-63900-98-603"],"award-info":[{"award-number":["60-63900-98-603"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People living with dementia can develop resistive behavior during eating and drinking, complicating food and fluid intake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to explore how relatives and healthcare professionals navigate care decisions, and to identify possible ethical dilemmas related to decision making and the impact on all involved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative multiple case study was conducted, nested in a prospective study. We identified cases where resistive behavior was observed in a person with dementia. We aimed at interviewing at least one relative and three healthcare professionals closely involved with a specific case. The interviews were transcribed verbatim and analyzed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of sixteen cases were eligible, of which five cases were included. Four cases concerned people residing in a nursing home, and one person was living at home. Three themes were identified from a total of sixteen interviews: 1) fundamental tension between autonomy and adequate nutrition, 2) understanding the person with dementia and the resistive behavior, and 3) solutions: searching for a personalized approach. This study contributes to the understanding of decision making in situations involving resistive behavior that adversely affects the intake of food and fluids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings emphasize the importance of a personalized approach that balances autonomy, quality of life, and adequate nutrition to provide the best care for people with dementia. The perspectives elicited in this study can help multidisciplinary teams to navigate this complex decision-making process.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261427800","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:41:58Z","timestamp":1773394918000},"page":"1950-1960","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating resistive behavior that adversely affects the intake of food and fluids in people living with dementia: A multiple case study"],"prefix":"10.1177","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0133-6695","authenticated-orcid":false,"given":"Eline Cornelia Pieternella","family":"van Buuren","sequence":"first","affiliation":[{"name":"Radboud University Medical Center"},{"name":"\u2018Joachim en Anna\u2019 Center for Specialized Geriatric Care, De Waalboog, Nijmegen, the Netherlands"},{"name":"Radboudumc Alzheimer Center, Nijmegen, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9063-7501","authenticated-orcid":false,"given":"Jenny Theodora","family":"van der Steen","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center"},{"name":"Radboudumc Alzheimer Center, Nijmegen, the Netherlands"},{"name":"Leiden University Medical Center"},{"name":"Cicely Saunders Institute, King's College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anouk Anna Maria","family":"van Dartel","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center"},{"name":"ZZG Center for Specialized Geriatric Care, Groesbeek, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0209-6942","authenticated-orcid":false,"given":"Raymond Theodorus Catherina","family":"Maria Koopmans","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center"},{"name":"\u2018Joachim en Anna\u2019 Center for Specialized Geriatric Care, De Waalboog, Nijmegen, the Netherlands"},{"name":"Radboudumc Alzheimer Center, Nijmegen, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7176-2796","authenticated-orcid":false,"given":"Christian","family":"Bakker","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center"},{"name":"Radboudumc Alzheimer Center, Nijmegen, the Netherlands"},{"name":"Groenhuysen Center for Geriatric Care, Roosendaal, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0675-9678","authenticated-orcid":false,"given":"Marieke","family":"Perry","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center"},{"name":"Radboudumc Alzheimer Center, Nijmegen, the Netherlands"},{"name":"General Medical Practice, Velp, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14654"},{"key":"e_1_3_3_3_2","unstructured":"Omgaan met afweergedrag bij eten en drinken van bewoners met dementie: Richtlijn voor verzorgenden niveau 3 in verpleeg- en verzorgingshuizen."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-021-02315-6"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2022.01.009"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.13404"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0969733021999748"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216313477178"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10633"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2024.04.039"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00699"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2006.12.006"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2016.02.006"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03320.x"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afab049"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/20.302"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac230"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-230135"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu16081163"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2008.03.011"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12542"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12746"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-018-0325-y"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1037\/13620-004"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaging.2012.12.007"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2022.104382"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-023-01165-w"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12624"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5884"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.09.012"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1590\/1980-5764-dn-2022-0092"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/0193945920979691"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.06.035"},{"key":"e_1_3_3_35_2","first-page":"878","article-title":"Executive summary of the position paper on the use of enteral nutrition in advanced dementia","volume":"69","author":"Pita Gutierrez F","year":"2022","unstructured":"Pita Gutierrez F, Alvarez Hernandez J, Ballesteros-Pomar MD, et al. Executive summary of the position paper on the use of enteral nutrition in advanced dementia. Endocrinol Diabetes Nutr (Engl Ed) 2022; 69: 878\u2013887.","journal-title":"Endocrinol Diabetes Nutr (Engl Ed)"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2023.0555"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.10.033"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.3390\/geriatrics6020044"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.12737"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/0300060520936069"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.16191"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-024-05420-4"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1270-4"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15904"},{"key":"e_1_3_3_45_2","first-page":"330","article-title":"End-of-life issues in advanced dementia: part 1: goals of care, decision-making process, and family education","volume":"61","author":"Arcand M","year":"2015","unstructured":"Arcand M. End-of-life issues in advanced dementia: part 1: goals of care, decision-making process, and family education. Can Fam Physician 2015; 61: 330\u2013334.","journal-title":"Can Fam Physician"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14654"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-024-01486-4"}],"container-title":["Journal of Alzheimer\u2019s Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261427800","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13872877261427800","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261427800","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T14:46:56Z","timestamp":1778165216000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13872877261427800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":46,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/13872877261427800"],"URL":"https:\/\/doi.org\/10.1177\/13872877261427800","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,13]]}}}