Tube Feeding Case Study

Even if a person with dementia can no longer make complex decisions, it is likely that they can make more basic decisions. Every effort should be made to get their input wherever possible. Once the person with dementia begins to lose capacity it is important that their carer and/or health care professionals are consulted and involved in decision making. This method is called the multidisciplinary approach. Macmillan Cancer Support (2012) describe a multidisciplinary team (MDT) as a group of doctors and other health professionals with expertise in a specific cancer, who together discuss and manage an individual patient’s care, planning the best treatment for the individual patient.

An example of how other health and emotional conditions could affect the nutritional needs of an individual with dementia is depression, as this could lead to a loss of appetite and also a lack of interest in food and drinks. For example, Mrs B has been depressed for quite sometime due to the death of her husband. She would prefer to be on her own most of the time. As a result of her lack of socialisation she became socially isolated. This affected her nutritional needs, as she didn’t feel like eating. It took a long time until she agreed to go to the dining room at meal times. Once dinner was served she would lose interest in eating and tended to return to the lounge without touching the meal. I consistently done my best to try and encourage her

Individuals diagnosed with dementia have to face with the prospect of gradual loss of the capacity to make their own decisions. They need to think about and make their choises about care, treatment and money when they are not able to speak for themselves at some time in the future.

There is a need to identify the level and type of support an individual requires when eating and drinking. Any support while eating or drinking is to be provided respecting the service user’s human dignity, while the carer is exhibiting warmth and a calm attitude. The care plan informs whether the service user is able to feed him/herself, or needs assistance. Many service users will feed themselves when starting their meal, but will get tired and will then require assistance. The hands of service users with Parkinson’s may have to be gently directed so that they manage eating independently. The carer may need to cut the food for the service user. Service users with chewing difficulties, or swallowing precautions, or a history of choking need to be supervised while eating. Of course, these service users will also get a soft diet. Service users living with dementia may reject food which to them resembles to gruesome things (e.g., they may think meat bits in a dark sauce are cocroaches), therefore person-centered support is important. Service users with learning disabilities may find it hard to estimate distances, so the carer will make sure plates and glasses are well within their reach.

1) describe how cognitive, functional and emotional changes with dementia can affect eating, drinking and nutrition.

Communication - The person with dementia may have problems communicating that they are hungry or that they don't like the food they have been given. They may communicate their needs through their behaviour. For example, they may refuse to eat or hold food in their mouth. Giving them a choice of food, or using prompts and pictures, may help.

- Describe how cognitive functional and emotional changes associated with dementia can affect eating drinking and nutrition:

After Alzheimer's is diagnosed in a parent, or other elderly family member, the caregiver has the task of deciding what the best form of care for the patient is. In order to do this they have to fully understand what the disease is, and

Dementia is a very common disorder that is more common in the older population. For people aged 60-69 the dementia rate is 1in 100, but in people over 80 the rate is 1in 6(A.Smith, 2011). Dementia is a terminal illness and the prognosis is grim, suffers are only expected to live 3 to 5 years after diagnosis (A.Smith, 2011). Dementia is divided into three stages early, middle and late. People can be in the late stage for many years. During the late stage the dementia patient suffers from a lot of different issues including but not limited to dysphagia, self-feeding, and eating problems. Nearly 50 percent of patients with dementia lose their ability to self-feed within 8 years after the onset of the disease (S.A. Thomas 2014).We know that malnutrition is a serious problem when it comes to dementia

Mary is a 69-year-old lady who has been diagnosed with dementia. She lives in a bungalow with her husband Sam who is 78 years old. Before Mary was diagnosed with dementia she lived a normal lifestyle which involved her going shopping, driving and also caring for her husband. Before Mary Retired she worked in the pottery industry for over 40 years. Marys husband Sam has previously had a stroke so he also struggles to manage as the stroke has affected his left side. They have 3 grown up children who live nearby but are all currently in full time work. Marys children regularly help Mary and Sam when they are not working but due to their own work and family commitments it is not very often. Marys children are also worried as they have seen a dramatic weight loss and change in Mary’s appetite. Mary has recently been admitted to the ward following a fall at home where she will be assessed although Mary is adamant she wants to return home after her hospital stay.

Focusing on dementia, it is not constantly possible to involve the dementia sufferers in the decision making course of their care without encouragement and assistance by

Aging is inevitable, with age comes certain conditions, and diagnoses that affect healthy aging in Canadians. In Canada, and across the world, there are institutions that help care for people with these diagnoses. Nurses are one of the members of the health care team, and they help to try and reduce risks that can exist in aging Canadians. The purpose of this paper is to explore the risks of malnutrition in aging Canadians living in institutions who have vascular dementia.

My mentor asked me to observe her feeding Mr Comer. She had prepared my learning the week previously by providing literature on the subject of feeding elderly patients and discussion on safe practice for feeding patients with dysphagia.

People who suffer from dementia may also be at risk of mal-nutrition. People with dementia rely on others to help them to organise their day to day life such as preparing their meals. People with dementia are at risk of mal-nutrition as they may not be physically able to provide themselves with a balanced diet, there may also be the issue that they are not able to remember whether they have eaten and therefore decide not to make themselves

Advance Directives by the patient designates no feeding tubes, artificial ventilation, or CPR. Concerns regarding alteration of mental status consequential to his illness provoke the physician to seek consultation from the designated Power of Attorney. Nursing responsibilities compel the nurse to consider if the proposed actions of Dr. G violate the patient’s rights of self determination and confidentiality and prompt the nurse to advocate for the patient’s desires regarding medical treatment. Health care providers have a responsibility to honor the patient’s autonomy and provide quality medical care (Badger, 2009 p122). Providing artificial nutrition and ventilation transgresses the patient’s directives and is unethical. The physician appears to be asserting a paternalistic approach in deciding what is best for this patient. Should the interventions be temporary and provide resolution of the condition, the physician can defend his actions as being healing and beneficial. However, there is a chance that the interventions may be permanent and futile; avoiding passive euthanasia and terminal dehydration, serving only to prolonging the illness. Violating the patient’s directives of care by performing invasive procedures can lead to legal incriminations of assault and battery.