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. 2024 Jun;15(3):771-775.
doi: 10.1007/s41999-024-00983-2. Epub 2024 May 9.

Decisions on eating and drinking in older adults admitted with pneumonia and referred for swallowing difficulties

Yuki Yoshimatsu  1   2 , Dharinee Hansjee  3 , Marianne Markowski  4 , Ryan Essex  4 , David G Smithard  5   6
Affiliations

Decisions on eating and drinking in older adults admitted with pneumonia and referred for swallowing difficulties

Yuki Yoshimatsu et al. Eur Geriatr Med. 2024 Jun.

Abstract

Purpose: Older patients with pneumonia are commonly restricted from oral intake due to concerns towards aspiration. Eating and drinking with acknowledged risks (EDAR) is a shared decision-making process emphasising patient comfort. As part of our project to find the barriers and facilitators of EDAR, we aimed for this initial study to see how frequently EDAR was selected in practice.

Methods: We performed a retrospective cohort study at an acute hospital where EDAR was initially developed, of patients aged ≥ 75 years-old admitted with pneumonia and referred to speech and language therapy.

Results: Out of 216 patients, EDAR decisions were made in 14.4%. The EDAR group had a higher 1-year mortality than the modified/normal diet groups (p < 0.001). Pneumonia recurrence rate did not differ significantly between the groups (p = 0.070).

Conclusion: EDAR decisions were comparatively less common and most were associated with end-of-life care. Underlying reasons for the low EDAR application rate must be investigated to maximise patient autonomy and comfort as intended by EDAR while minimising staff burden.

Keywords: Aspiration pneumonia; Choking; Comfort feeding; Dysphagia; Modified diet; Risk feeding.

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Conflict of interest statement

The corresponding author is supported by The Japanese Respiratory Society Fellowship Grant. This study was funded by the Great Britain Sasakawa Foundation (Butterfield Award). The sponsors had no role in this study design, review process, writing of the manuscript, or decision to publish. The authors received no other financial support for the research, authorship and publication of this article. The authors declare that they have no other competing interests.

Figures

Fig. 1
Fig. 1
Patient selection. CAP community-acquired pneumonia, HAP hospital-acquired pneumonia, SLT speech and language therapist
See this image and copyright information in PMC

References

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