Resumo

ESQUIVEL, Sofia; SAMPAIO, Joana Filipa  e  SILVA, Cristiana Teixeira da. Tube feeding to sustain life or prolong dying: A team reflection on a clinical case. Rev Port Med Geral Fam [online]. 2014, vol.30, n.1, pp.44-49. ISSN 2182-5173.

The use of artificial nutrition and hydration in patients in the late stages of dementia is controversial. The prevalence of dementia will continue to increase with the aging population so this topic will become increasingly important. In the more advanced stages of dementia, patients typically are unable to walk or feed themselves, becoming incontinent and aphasic. When confronted with a patient with terminal dementia and dysphagia, the authors searched the literature for the best approach to nutrition for the patient. The decision to insert a nasogastric tube or a percutaneous endoscopic gastrostomy (PEG) for elderly patients with advanced dementia is one of the hardest decisions for health professionals and relatives. The studies reviewed have failed to show that artificial feeding is advantageous in the terminal stage of the disease. They concluded that feeding tube placement in these patients is not helpful for the prevention of pressure ulcers, malnutrition, or for prolonging survival. This procedure may reduce quality of life because of the change in feeding routines. It may require immobilization or sedation of the patient to prevent them from removing the tube. Family members should be more informed to make better decisions to improve the quality of life in the last days of the patient. Further studies are needed so that the risks and benefits of tube feeding are clarified as well as the advantages and disadvantages of each method.

Palavras-chave : Advanced Dementia; Feeding Tubes; Malnutrition; Functional Status; Survival.

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