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Review
. 2009 Dec;9(6):544-8.
doi: 10.7861/clinmedicine.9-6-544.

Swallowing problems and dementia in acute hospital settings: practical guidance for the management of dysphagia

H A Smith  1 , J Kindell, R C Baldwin, D Waterman, A J Makin
Affiliations
Review

Swallowing problems and dementia in acute hospital settings: practical guidance for the management of dysphagia

H A Smith et al. Clin Med (Lond). 2009 Dec.

Abstract

There is little evidence to support tube feeding in advanced dementia although it is still frequently used in acute hospital settings. Patients present with complex problems and are often unable to make decisions about their healthcare needs. Multidisciplinary teams may be challenged by the difficult ethical decisions they are required to make in the best interests of their patients. This paper guides decision making in the management of patients with dementia and dysphagia in the acute hospital setting. A structured approach to information gathering, assessment and management is outlined with practical application of recent published guidelines and research evidence, which ensures appropriate individualised care.

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Figures

Fig 1.
Fig 1.
Dementia and dysphagia in acute hospital care decision-making. IMCA = independent mental capacity advocate; LPA = lasting power of attorney; NG = nasogastric; PEG = percutaneous endoscopic gastrostomy.
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