Structural equation modelling has already been used to study the relationship between feeding difficulty and nursing intervention in elderly people with dementia. Four models were tested and one provided an acceptable fit to the data. However, there were limitations in terms of sample size and the scales used to measure the variables related to feeding difficulty and nursing intervention. In the present study the sample size has been increased and the scaling of variables has been improved and an additional model has been tested. The best fitting model introduces a latent state variable to explain the relationship between feeding difficulty and nursing intervention. In order to study this relationship further several lines of investigation are suggested, including trait validation and state experimentation. These will be explained in the paper.