A 92-year-old woman with a CFS of 8 is in a care home with end-stage dementia. She has had three episodes of aspiration pneumonia in the past 6 months...

Question

A 92-year-old woman with a CFS of 8 is in a care home with end-stage dementia. She has had three episodes of aspiration pneumonia in the past 6 months. She is being fed pureed food and thickened fluids. She frequently coughs during meals and appears to aspirate. The SLT assessment confirms an unsafe swallow. The family asks about continuing oral feeding despite aspiration risk. What is the MOST appropriate approach?

Accepted Answer

Discuss with the family that careful hand feeding with comfort feeding (small amounts of food for pleasure, accepting the aspiration risk) may be more appropriate than complete cessation of oral intake in the context of end-of-life care, while respecting the patient's dignity and comfort

Answer

Stop all oral intake immediately to prevent further aspiration

Answer

Insert a PEG tube to prevent aspiration

Answer

Refer to a surgeon for a laryngeal diversion procedure

Answer

Commence total parenteral nutrition

uk-dgm MCQ (SBA): Comfort Feeding in End-Stage Dementia