A 75-year old resident in the nursing home has end stage dementia and experiences a 10-pound weight loss over the course of 2 months. The resident has become increasingly difficult to feed and often spits out food, pockets food, and frequently drools. The
a. Recommend to the physician that a gastric feeding tube be placed.
b. Recommend to the physician that a swallowing evaluation be done.
c. Amend the care plan to include vigorous feeding by the nursing assistants.
d. Assure the family that feeding issues are often a characteristic of end-stage dementia.
ANS: B
It is important to do a careful assessment for swallowing disorders and other factors that in-fluence intake before considering severe dietary restrictions or feeding tubes, especially in patients with dementia. Feeding tubes are not the first line of action; a complete assessment is done to identify the problem. The word vigorous implies force-feeding, which is never recommended. It would be especially contraindicated in this patient because there is evi-dence of a swallowing problem (spitting out food, pocketing food, and excessive drooling). While feeding issues are common at this stage of dementia, this option does not address the family's concern.
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