Title

Enteral Nutrition and Dementia Integrating Ethics.

Document Type

Article

Publication Date

6-1-2018

Keywords

advance directives; dementia; dysphagia; enteral nutrition; ethics; feeding; tube feeding

Abstract

This narrative review highlights topics related to feeding patients with dementia, including the use of ethical principles and legal precedents; specifies guidelines and practice recommendations; provides an option to assist in applying the recommendations, such as comfort feedings instead of enteral nutrition; promotes the use of early advance care planning to achieve medical therapies based on an individual's wishes; and provides 3 case studies to demonstrate the clinical application of the information presented in the article. Enteral nutrition guidelines and recommendations have been developed by the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics for individuals with dementia. Predominately these guidelines and recommendations focus on patients with advanced dementia due to the dysphagia and progressive disease process. Despite the research and recommendations to forgo enteral nutrition in advanced dementia, the practice continues. The detailed case studies, integrating an interprofessional approach, provide tools for clinicians to incorporate ethical principles and address the communication aspect when dealing with families and surrogate decision-makers for individuals with advanced dementia.

Department

Speech Therapy

Department

Geriatrics

Department

Biomedical Ethics

Volume

33

Issue

3

First Page

377

Last Page

387

PubMed ID

29665095

Journal Title

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

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