Considering the hazards of aspiration pneumonia and the problems of providing adequate nutrition to a patient with dementia, the placement of a gastrostomy or other enteral feeding tube would seem logical. While having a role in some patients with dementia, feeding tubes may be placed more for the convenience of the caregivers than for the benefit of the patient.


Perceived benefits of enteral feeding:

(1) simpler

(2) easier

(3) faster


Problems with enteral feeding tubes:

(1) complications during insertion and repositioning

(2) may be associated with diarrhea

(3) may be associated with aspiration pneumonia

(4) may be pulled at by the patient who may not understand why it is there

(5) may require use of restraints to prevent from being pulled at


Benefits of oral feedings:

(1) provides some degree of social interaction for the patient

(2) provides some level of orientation and stimulation


Problems with oral feedings:

(1) can be time consuming

(2) can be frustrating

(3) can be messy

(4) can be associated with aspiration pneumonia


Strategies for improving oral nutrition:

(1) Time meals for when the patient has the greatest cognitive function.

(2) Have the person sit upright while feeding.

(3) Keep portions small (less than one teaspoon).

(4) Place the food well into the mouth.

(5) Remind the patient to swallow several times after each mouthful.

(6) Encourage a small cough when done swallowing.

(7) Limit clear fluid intake to small volumes.

(8) Allow plenty of time.


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