Purpose: to describe the medical criteria and the role of the speech therapist’s procedure in indicating and removing alternative feeding routes in older adults. Methods: a cross-sectional study conducted with the medical team of a public hospital. A questionnaire was administered with items on the medical criteria to indicate and remove alternative feeding routes and on the speech therapist’s work. Descriptive statistics were used for categorical variables in relative and absolute frequencies. Results: the data obtained from the participation of the 59 physicians enabled the main criteria for the indication of an alternative feeding route to be defined as follows: consciousness level, clinical condition, nutritional status, respiratory condition, and dysphagia assessment by a speech therapist. The main criteria for the removal of the alternative feeding route were the stable clinical and respiratory conditions, adequate nutritional support, and recommendation by a speech therapist. Conclusion: the clinical and respiratory conditions, nutritional status, and the speech therapist’s procedure were the main criteria considered by the medical team in the decisions to indicate and remove the alternative feeding route. The work of the speech therapist was relevant in both medical decisions, regarding the alternative feeding route in older patients.
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