Aspiration with pneumonia is a major cause of morbidity and mortality in a patient with dementia. Often this can be reduced by careful planning.
Patient related factors increasing the risk for aspiration:
(1) dysphagia
(2) oral apraxia
(3) agitation
Drug therapy:
(1) sedatives
(2) antipsychotic agents, especially in during the first week of therapy
Poor oral feeding technique:
(1) feeding while the person is supine
(2) giving too large of a food bolus
(3) feeding while the person is refusing to eat
(4) not paying attention to how well the patient is swallowing
Complications:
(1) vomiting
(2) gastroesophageal reflux (GERD)
Placement of an enteral feeding tube is not a guarantee against pulmonary aspiration, especially if the patient becomes agitated.
