Category: Dementia – Nutrition and Hydration

The focus of this research is on the issue of life-sustaining treat-ment, specifically on the social and ethical implications of tube feeding. The treatment decision, based on values of life and dignity, involves sustaining lives that many people consider not worth living. It explores the moral approach to caring for these patients and review the history of the debate on artificial nutrition and hydration showing the impact of the varying perceptions of the value of these patients’ lives on changing norms. The authors argue that in light of the value of solidarity, decisions about life-sustaining treatment for patients with advanced dementia should be made on a case-by- -case basis, as with any other patient, in consideration of the medical implications of the interven-tion which might best serve the goals of care (i.e., care and respect for dignity) for the individual patient.

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This study aims to explore the perceptions of staff caregivers regarding factors affecting optimal nutrition and hydration for individuals living in Specialised Dementia Care Units in New Zealand.
The results of the study identifies two main themes The first theme ‘It’s about the individual’ encompassed individual factors such as appetite, food appeal, and cognitive and functional abilities. The second theme ‘It’s about the environment’ encompassed factors relating to the dining environment, the social aspects to dining and the provision of support with mealtime activities. Conclusions: Factors affecting nutrition and hydration in people living with dementia are complex and inter-related. Organisations providing specialised dementia care, their staff and foodservice providers should focus on both the individual and environment to ensure optimal nutrition and hydration for the people in their care.

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The purpose of this minireview is to explore the issue of multi-nutrient intervention in the
management of AD with special focus on medical foods and Mediterranean diet. The findings of this review study indicate that multi-nutrient intervention seem to bring many benefits for AD patients such as the delay of cognitive decline, non-invasive and less costly treatment or none or fewer side effects. In addition, to minimize the risk of AD, a multi-factorial healthy lifestyle approach should be implemented by people already at their mid-life.

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The aims of this systematic review were to summarize the evidence considering diet as a protective or risk factor for AD, identify methodological challenges and limitations, and provide future research directions.
Despite the methodological limitations,
the finding that 50 of the 64 reviewed studies revealed an association between diet and AD incidence offers
promising implications for diet as a modifiable risk factor for AD.

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Background & aims Despite guidelines, long-term enteral nutrition (EN) through percutaneous endoscopic gastrostomy (PEG) is often prescribed to older individuals with dementia and eating problems (refusal to eat or dysphagia). The aim of this prospective observational non-randomized un-blinded study was to assess the role of this procedure on risk of mortality. Conclusions: In elderly individuals with dementia and eating problems, long-term PEG feeding increases the risk of mortality and should be discouraged.

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Many doctors believe that tube feeding does not help people with advanced dementia. Scientific studies suggest that people with dementia who have feeding tubes do not live longer or gain weight compared with those who are carefully hand fed. However, these studies are not very helpful because of flaws in design, which are discussed in this article. Guidelines from professional societies make a blanket recommendation against feeding tubes for anyone with dementia, but an individual approach that takes each person’s situation into account seems more appropriate. Patients and surrogates should be aware that the guidelines on this topic tend both to underestimate the benefit and exaggerate the burdens of tube feeding.

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The aim of this article is to explore the generalized problems with nutrition, diet, feeding, and eating reported among patients with dementia. Concludes that Individuals with dementia frequently develop serious feeding difficulties and changes in eating and dietary habits. The changes may be secondary to cognitive impairment or apraxia, or the result of insufficient caregiving, or the consequence of metabolic or neurochemical abnormalities occurring as part of the dementing process.

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Objective of this stusy was to provide an assessment of nutritional status of patients affected by Alzheimer’s disease (AD) living at home and of their caregivers by means of Mini Nutritional Assessment (MNA), and to explore the influence of different factors on nutrition. Concludes that corrective measures should be taken in order to early identify nutritional deficiencies and risk of malnutrition observed with high rate in both groups of AD patients and their caregivers; in these subjects a nutrition education program and intervention policies are mandatory to restore nutritional status.

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A link between aging, dementia and malnutrition is established and leads to poor prognosis. Endoscopic gastrostomy (PEG) is used without clear benefit on survival, nutritional status or quality of life. This work aims to assess the effectiveness of PEG-feeding for nutritional support in patients with dementia. Study concludes that PEG should be considered on an individual basis in patients with moderate-severe dementia when risk of malnutrition and aspiration is present.

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The purpose of this study was to explore perceptions of home healthcare nurses related to suffering, artificial nutrition and hydration in people with late-stage dementia, and if these perceptions influence care to people with dementia and their families. Seventeen home healthcare nurses participated in this study. Although many of the nurses reported that artificial nutrition and hydration was of comfort to the patient and family because of the potential for “starving,” they also felt it prolonged the patient’s suffering due to the invasive procedure, need for restraints, and possibility of fluid overload. Several nurses felt that artificial nutrition and hydration gave a sense of false hope to the family that the patient would live longer. The perceptions of these home healthcare nurses influence their care to people with dementia and their families related to artificial nutrition and hydration, possibly based on experience. Their perceptions could influence family decisions regarding treatment options.

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