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Updated: Nov 28, 2025

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Eating Problems in Advanced Dementia: Navigating Difficult Conversations.

Erika R Manu1, James T Fitzgerald2, Patricia B Mullan3

  • 1Assistant Professor, Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School; Physician, VA Ann Arbor Geriatric Research, Education and Clinical Center (GRECC).

Mededportal : the Journal of Teaching and Learning Resources
|November 26, 2020
PubMed
Summary
This summary is machine-generated.

An interactive seminar improved internal medicine residents' confidence in managing eating problems and discussing care goals for advanced dementia patients. This training enhances geriatric and palliative care skills for future practice.

Keywords:
Advanced DementiaCase-Based LearningDysphagiaGeriatricsGeriatrics EducationHospice & Palliative MedicinePalliative Care EducationResident Education

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Area of Science:

  • Geriatric Medicine
  • Palliative Care
  • Medical Education

Background:

  • Advanced dementia (AD) frequently causes eating and swallowing difficulties, impacting nutrition and quality of life.
  • Palliative care for AD necessitates skills in symptom management, caregiver communication, and establishing goals of care.
  • Internal medicine (IM) residents report insufficient training in managing AD patients.

Purpose of the Study:

  • To assess the impact of an interactive seminar on residents' skills in managing advanced dementia.
  • To improve residents' ability to address nutritional issues and goals of care in AD patients.

Main Methods:

  • A small-group interactive seminar was developed, featuring a trigger video of a family meeting about eating problems in AD.
  • Case-based learning, small-group discussion, and learner reflection were utilized.
  • The seminar was piloted with 82 internal medicine, medicine-pediatrics, and neurology residents.

Main Results:

  • Residents reported high satisfaction and found the educational content clinically relevant.
  • Statistically significant improvements in self-reported confidence in dementia-specific skills were observed (p < .001).
  • Large to very large effect sizes (Cohen's d = 1.3-1.7) indicated substantial impact.

Conclusions:

  • The seminar effectively enhanced residents' self-efficacy in managing nutritional issues and goals-of-care discussions for AD patients.
  • The training imparted crucial geriatric and palliative concepts, preparing residents for future care of older adults with AD.