AbstractAims and ObjectivesTo understand the nutritional status, observing eating difficulties during mealtimes for people living with dementia in acute care settings.BackgroundChanged eating behaviours caused by declining cognitive function is common in people living with dementia which can lead to malnutrition. Malnutrition is associated with prolonged hospitalisation and increased mortality. People living with dementia in acute care settings are at high risk of malnutrition. This highlights the importance of better understanding the nutritional intake and eating behaviours of people living with dementia in acute care settings.DesignThis study is a cross‐sectional, observational study.MethodsData of mealtime difficulties and nutritional status of people living with dementia were collected in four geriatric care wards (in acute or sub‐acute hospitals) by using Feeding Difficulty Index and Mini Nutritional Assessment Short‐Form. The STROBE checklist was used throughout this study.ResultsThe study included 94 people living with dementia. The median age of the participants was 85.86 years old, with a Feeding Difficulty Index of 8.27 and had stayed in hospitals for average 14.46 days, with an average total feeding time of 24.61 min. Only 1.2% of participants were considered to be in normal nutritional status, whereas 72.1% were malnourished. All participants required partial or full assistance during mealtime. Participants with higher scores on the Feeding Difficulty Index have longer total feeding times, compared to those with lower scores.ConclusionsMalnutrition is prevalent in people living with dementia. People living with dementia demonstrate varying mealtime difficulties depending on the level of dependence. Mealtime assistance training programs are warranted and are beneficial for nursing staff and family members to improve their feeding skills and knowledge.No patient or public contributionThis study did not involve patients, service users, caregivers or members of the public.Relevance to clinical practiceThe study is relevant to clinical practice by identifying changed eating behaviours or mealtime difficulties in people living with dementia in acute care settings can significantly decrease the risk of malnutrition.