L15 Dementia and Feeding

Question 1

What were the overall results from the systematic reviews looking at tube feeding in patients with advanced dementia

Answer 1

• No differences in mortality
• No association with longer or shorter survival
• nutrition and pressure ulcer outcomes mixed
• mixed evidence about aspiration pneumonia

Question 2

T or F: The study of 1500 ASHA members found that 70% were willing to consider oral feeding despite increased risk of aspiration

Answer 2

True

Question 3

What is comfort feeding?

Answer 3

careful hand feeding, unless it is distressing to the patient
-goal is to maximize comfort

Question 4

T or F: comfort feeding has a focus on nutrition, hydration and safety

Answer 4

False - focus is away from these things, towards comfort

Question 5

In comfort feeding, weight loss is ______ and _________

Answer 5

okay

expected

Question 6

____________ may be an anticipated consequence of comfort feeding

Answer 6

aspiration pneumonia

Question 7

The ________ aspects of feeding are of greatest importance in comfort feeding only

Answer 7

relational

Question 8

How does comfort feeding only ‘bridge the gap’

Answer 8

• provides a 3rd option for families between eat/starve and care/no-care dichotomies
• shifts conversation from do not, to do this language

Question 9

What are the four objectives when delivering bad news - SPIKES

Answer 9

• gathering information from the patient
• transmitting the medical info
• providing support to the patient
• eliciting the patients collaboration in developing a strategy or treatment plan for the future

Question 10

What does SPIKES stand for ?

Answer 10

1) Setting up the interview
2) assessing patient’s perception
3) obtaining the patients invitation
4) giving knowledge and information
5) address emotions with empathy
6) strategy and summary