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Enhancing the decision-making process when considering artificial nutrition in advanced dementia care
1Senior Lecturer Adult Nursing, Cardiff University, UK.
International Journal of Palliative Nursing
|May 23, 2019
Summary
Artificial nutrition and hydration (ANH) may not improve comfort or survival in advanced dementia. This review challenges the routine use of invasive ANH, offering evidence for informed family decisions.
Area of Science:
- Gerontology
- Palliative Care
- Neurology
Background:
- Nutritional issues are common in late-stage dementia, prompting family requests for artificial nutrition and hydration (ANH).
- One-third of US nursing home patients with severe cognitive impairment receive feeding tubes, often driven by family fears of hunger and thirst.
- UK practices differ, with rare use of artificial hydration in dementia patients across care settings.
Purpose of the Study:
- To evaluate the evidence supporting the use and non-use of artificial nutrition and hydration (ANH) in dementia care.
- To provide evidence-based support for families and caregivers making feeding decisions for individuals with dementia.
Main Methods:
- A comprehensive literature review was conducted.
- The review examined existing evidence regarding ANH for patients diagnosed with dementia.
Main Results:
- The implementation of invasive ANH globally is questioned.
- Evidence does not consistently show ANH improves comfort, survival rates, or wound healing.
- The risk of aspiration does not appear to be significantly altered by ANH.
Conclusions:
- This review challenges the widespread implementation of invasive artificial nutrition and hydration (ANH).
- ANH does not guarantee enhanced comfort, survival, or wound healing in dementia patients.
- The risk of aspiration remains a significant consideration, irrespective of ANH use.
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