Feeding issues occur in 90 % of individuals with advanced dementia and is typically the last activity of daily living (ADL) lost prior to death
Enteral feeding in elders with advanced dementia has not been shown to
Prolong survival
Increase comfort
Improve nutrition
Prevent aspiration
Adverse effects of feeding tubes include
Increased use of chemical and physical restraints
Tube dislodgement, malfunction, and blockage
Skin breakdown and cellulitis at tube site
GI side effects – nausea, gas, vomiting, diarrhea, and gastroesophageal reflux
Benefits of hand-feeding
Increased caregiver interaction
Ability to enjoy the taste of food and drink
Increased satisfaction among family of elders in long-term care with advanced dementia
References
1.
American Geriatrics Society Ethics Committee and Clinical Practice and Models of Care Committee. American Geriatrics Society feeding tubes in advanced dementia position statement. J Am Geriatr Soc. 2014;62(8):1590–3.CrossRef
2.
Rahnemai-Aza AA, Rahnemaiaza AA, Naghshizadian R, et al. Percutaneous endoscopic gastrostomy: indications, technique, complications and management. World J Gastroenterol. 2014;20(24):7739–51.CrossRef
3.
Kuo S, Rhodes RL, Mitchell SL, et al. Natural history of feeding-tube use in nursing home residents with advanced dementia. J Am Med Dir Assoc. 2009;10(4):264–70.CrossRefPubMedPubMedCentral
4.
5.
Mitchel SL, Teno JM, Kiely DK, et al. The clinical course of advanced dementia. N Engl J Med. 2009;361(16):1529–38.CrossRef
6.
Reisberg B, Franssen EH. Clinical stages of Alzheimer’s disease. In: De Leon MJ, editor. An atlas of Alzheimer’s disease. New York: Parthenon Publishing Group; 1999. p. 11–20.
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Palecek EJ, Teno JM, Casaret DJ, et al. Comfort feeding only: a proposal to bring clarity to decision-making regarding difficulty with eating for persons with advanced dementia. J Am Geriatr Soc. 2010;58(3):580–4.CrossRefPubMedPubMedCentral
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