SciELO - Scientific Electronic Library Online

 
vol.27 issue1Rectus Sheath Hematoma in a Medical Ward: Case-SeriesNEBio’s Opinion: “Feeding on Advanced Dementia” author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • Have no similar articlesSimilars in SciELO

Share


Medicina Interna

Print version ISSN 0872-671X

Abstract

PESSOA, Ana et al. Feeding in Advanced Dementia: Consensus Report from the Portuguese Society of Internal Medicine and Portuguese Enteral and Parenteral Nutrition Society. Medicina Interna [online]. 2020, vol.27, n.1, pp.77-85. ISSN 0872-671X.  http://dx.doi.org/10.24950/Guidelines/Consensus/1/2020.

Dementia is a progressive neurological syndrome without cure whose prevalence is increasing due to population ageing. There is a lack of knowledge among healthcare professionals and caregivers regarding the best feeding approach in patients with advanced dementia. As there are no national recommendations on this subject, a consensus report from the Portuguese Society of Internal Medicine and the Portuguese Enteral and Parental Nutrition Society was made, clarifying existing guidelines regarding the approach of eating difficulties in these patients. Advanced dementia is a terminal condition where patient comfort should be the goal. These patients are usually bedbound, have limited ability to communicate verbally and have difficulty eating. In this population, current literature does not support tube feeding (nasogastric tube, nasojejunal tube, percutaneous gastrostomy or percutaneous jejunostomy feeding), which is associated with higher rates of infection, greater use of chemical and physical restraints and development of pressure ulcers. As an alternative, careful hand feeding should be offered (comfort feeding). From an ethical and legal standpoint, it is acceptable not to use tube feeding in the terminal phase of dementia if it is against patient values and offers no benefits. This decision should be made using a multidisciplinary approach including the patient (if possible), legal representative, caregivers, family and healthcare professionals, in order to establish an individual care plan allowing decision making in the patient’s best interest.

Keywords : Aged; Aging; Dementia; Eating; Feeding Methods; Palliative Care.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )

 

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License