A Geriatrician's Guide to Enteral Feeding

Drickamer, Margaret A.; Cooney, Leo M.

doi:10.1111/j.1532-5415.1993.tb06744.x

Cited by 22 publications

(7 citation statements)

References 26 publications

(27 reference statements)

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“…The bedside evaluation of swallowing by the speech-language pathologist should be performed. 9 In addition, the videofluoroscopic examinations that include measurement of oral and pharyngeal transit times, evaluation of oral and pharyngeal motility patterns, and observation of the presence or absence of aspiration are important to diagnose this disease. 10 The swallowing reflex test and swallowing provocation test that evaluate the threshold and latency a small amount of distilled water into the pharynx are also helpfui.ll- 13 Clinical diagnosis can be made by these manifestations and chest radiograph.…”

Section: Discussionmentioning

confidence: 99%

Importance of Diffuse Aspiration Bronchiolitis Caused by Chronic Occult Aspiration in the Elderly

Matsuse

Oka

Kida

et al. 1996

Chest

146

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Section: Discussionmentioning

confidence: 99%

Importance of Diffuse Aspiration Bronchiolitis Caused by Chronic Occult Aspiration in the Elderly

Matsuse

Oka

Kida

et al. 1996

Chest

146

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“…Moreover, while Kaiser-Jones' data suggest that nurses view tube-feeding as a 'somewhat casual practice, similar to the use of catheters and restraints in nursing homes', our data support that nurses' attitudes towards tube-feeding can be influenced by ethical and medical variables. However, little attention seems to be paid to enteral feeding side-effects and limitations (Drickamer and Cooney, 1993;Finucane, 1995). In fact, it has been shown that tube-feeding does not prevent aspiration pneumonia (Drickamer and Cooney, 1993), physical restraints are often required to prevent tube removal by the patient, tube-feeding may not prevent weight loss-even when adequate calories and protein are provided-and it deprives patients of interaction with the staff during the feeding process (Sachs et al, 1995;Quill, 1989;Evans and Strumps, 1989).…”

Section: Discussionmentioning

confidence: 99%

“…Specific educational programmes should therefore be planned. Nurses and other health care professionals should receive concrete, insightful and culturally sensitive instruction in the optimal care of dying demented patients and about enteral feeding (Drickamer and Cooney, 1993;Peck et al, 1990;AGS Ethics Committee, 1995;Sachs et al, 1995).…”

Section: Discussionmentioning

confidence: 99%

“…Guidelines will be underpinned by the view that a careful balance between maintenance of comfort and prevention of death should be sought for any severely demented patient; relief of symptoms, not limited to pain, should be addressed by both pharmacological and non-pharmacological means (Hilfiker, 1983;Wanzer, 1984;Black and Jolley, 1990;Drickamer and Cooney, 1993;High et al, 1994;Weatherall, 1994;AGS Ethics Committee, 1995;Helme, 1995;Sachs et al, 1995).…”

Section: Discussionmentioning

confidence: 99%

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Geriatric Nurses? Attitudes Towards the Use of Nasogastric Feeding-Tubes in Demented Patients

Zanetti

Bianchetti

Zanetti

et al. 1996

Int. J. Geriat. Psychiatry

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Geriatric nurses’ attitudes towards the use of nasogastric feeding‐tubes in severely demented patients were evaluated. A questionnaire was administered to 232 geriatric nurses asking whether they would favour enteral feeding for demented patients who were unable or refused to eat. The great majority of nurses (73.3%) were favourable; previous experience with nasogastric feeding‐tubes and a moderate to high level of religiosity were both significantly associated with this attitude. For the great majority (70.6%) of those favourable the patient's mental status was immaterial to their attitude. Also irrelevant were patients’ and/or caregivers’ wishes and economic and quality of life issues. This survey suggests that the majority of nurses consider enteral feeding as an ordinary basic practice, disregarding the complexity of the problem, which needs an individualized, multifaceted approach.

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“…Alternate means of feeding then becomes a consideration when the demented or diseased patient is unable to ingest food for any reason. Nutritional supplementation may be enteral or parenteral, and enteral nutrition is the preferred route if the gut is functional 1 .…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly

Chen

Shih

Bair

et al. 2011

International Journal of Gerontology

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s u m m a r y Today we are faced with an aging society that may develop malnutrition because of dysphagia related to dementia, stroke, and malignancy seen often in the elderly. The preferred form of nutritional supplementation for this group is enteral nutrition, and the most appropriate long-term method is by use of a gastrostomy. Percutaneous endoscopic gastrostomy (PEG) was first introduced in 1980 as an alternative to the traditional operative procedure and rapidly became the preferred procedure. In geriatric patients, the principal indications are neurological dysphagia and malnutrition, related to an underlying disease or anorexia-cachexia in very elderly. PEG is contraindicated in the presence of respiratory distress, previous gastric resection, total esophageal obstruction, coagulation disorders and sepsis in the elderly. Common complications include wound infection, leakage, hemorrhage, and fistula in the general population, but aspiration pneumonia is the major case of death in this group. Risks and complications of PEG must be discussed with patients and their families; and the decision for percutaneous endoscopic gastrostomy insertion should only be made after careful consideration and discussion between managing physicians, allied health professionals, and the patient and/or family. Four ethical principles may help make feeding decisions: beneficence, non-maleficence, autonomy and justice. Attentive long-term care after tube replacement is mandatory. Acceptance of percutaneous endoscopic gastrostomy placement by patients and their families tends to increase once favorable outcomes are offered.

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A Geriatrician's Guide to Enteral Feeding

Cited by 22 publications

References 26 publications

Importance of Diffuse Aspiration Bronchiolitis Caused by Chronic Occult Aspiration in the Elderly

Importance of Diffuse Aspiration Bronchiolitis Caused by Chronic Occult Aspiration in the Elderly

Geriatric Nurses? Attitudes Towards the Use of Nasogastric Feeding-Tubes in Demented Patients

Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly

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