Fulfilling nutritional requirements

Feeding behaviors in mid-stage Alzheimer's disease: A review

Nutritional problems associated with dementia and Alzheimer's disease (AD) are of concern and have been documented in the literature for many years.1 Despite this emphasis, the complexity of assessing the AD client's eating or feeding behaviors as well as nutritional status has only recently been recognized in practice and in research. This literature review presents current research and study of the nutritional status, problem feeding behaviors and therapy of AD clients.

Environmental issues related to visibility and consumption of food in an Alzheimer's disease unit

The importance of food and food choices as a physical, social, and psychological component of well-being is well documented. However these issues have not been systematically examined with the cognitively disabled. This study explores how presentation of food and snacks can encourage AD patients in the early and middle stages of the disease to independently satisfy hunger and thirst. Neither visible nor accessible refrigerators greatly increased the incidences of resident independence in snacking. Results suggest that residents' inability to select snacks independently may be inadvertently hampered by caregivers' perceptions of excess disability.

Ethical concerns in a long-term tube feeding study

Five ethical concerns about decision-making in relation to tube feeding were determined through secondary analysis of findings from a chart review study examining long-term tube feeding practices. The five ethical concerns are: (1) who should make the decision to tube feed? (2) how should tube feeding decisions be made? (3) what are valid reasons for initiating and continuing tube feeding? (4) is it permissible to withdraw tube feeding once it is initiated? and (5) is tube feeding an effective and appropriate life supporting technology? Ethical concerns are described, using examples from research data. Implications for health care follow.

Clinical considerations. Tube feeding in the elderly

1. The major indication for tube feeding is the inability to ingest sufficient nutrients by mouth in the presence of a functioning gastrointestinal tract. 2. Diarrhea, a frequent complaint, may be due to a variety of factors, including medication side effects, bacterial contamination of formula, viral infection, low albumin, high osmolality of the formula, too rapid infusion rate, and fecal impaction. 3. Aspiration of the tube feeding resulting in pneumonia is a serious and potentially life-threatening complication seen more frequently in patients with altered mental status or the inability to protect their airway. 4. Key items in the nutritional assessment include body weight; weight loss; visceral protein estimation, eg, albumin; exercise tolerance; and muscle strength.