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Nutrition in Advanced Dementia

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1. Dementia: assessment, management and support for people living with dementia and their carers

, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Dementia: assessment, management and support for people living with dementia and their carers (...) like to be contacted again at a specified future date. 1.1.10 Ensure that people living with dementia and their carers know how to get more information and who from if their needs change. 1.1.11 T ell people living with dementia (at all stages of the condition) about research studies they could participate in. Advance care planning Advance care planning 1.1.12 Offer early and ongoing opportunities for people living with dementia and people involved in their care (see recommendation 1.1.7

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

2. Nutrition in Advanced Dementia

Nutrition in Advanced Dementia Nutrition in Advanced Dementia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Nutrition in Advanced (...) Dementia Nutrition in Advanced Dementia Aka: Nutrition in Advanced Dementia , Dementia Related Malnutrition II. Enteral Feeding Tube use is not recommended No support for continued use in the literature Conscientious hand feeding is preferred alternative Previously used for Nutrition in Advanced Dementia prophylaxis (unproven) (unproven) reduction (unproven) Improved survival and function (unproven) III. General measures to improve food intake See for possible limitations Strong flavors should be used

2018 FP Notebook

3. Cachexia and advanced dementia. (PubMed)

among the chronic clinical conditions of sarcopenia, malnutrition, and frailty in the elderly. We discuss the clinical implications of these new insights, with particular attention to the challenging question of nutritional needs in advanced dementia and the utility of tube feeding in order to optimize the management of end-stage dementia.© 2019 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting (...) Cachexia and advanced dementia. Cachexia is a complex metabolic process that is associated with several end-stage organ diseases. It is known to be also associated with advanced dementia, although the pathophysiologic mechanisms are still largely unknown. The present narrative review is aimed at presenting recent insights concerning the pathophysiology of weight loss and wasting syndrome in dementia, the putative mechanisms involved in the dysregulation of energy balance, and the interplay

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2019 Journal of cachexia, sarcopenia and muscle

4. The outcomes of long term home enteral nutrition (HEN) in older patients with severe dementia. (PubMed)

the harmful effects of home enteral nutrition administered via the nasogastric tube and percutaneous endoscopic gastrostomy in patients with advanced dementia in terms of mechanical, gastrointestinal and metabolic complications, to estimate the survival, to explore the risk factors for mortality and to compare the outcomes of patients with advanced dementia with those of patients without dementia.The retrospective observational study was carried out on 585 consecutive patients of the mean age of 85.6 (...) without dementia vs. 0.35/1000 days for patients with dementia (p = 0.252). The Kaplan Mailer analyses showed that there was no evidence to support the theses on poorer prognosis of survival of patients with dementia (median survival was 193 days for patients without dementia vs. 192 days for patients with dementia, (p > 0.05)). The female gender, advanced age, nasogastric tube, diabetes mellitus and chronic renal failure were identified as risk factors. Subjects whose Geriatric Nutritional Risk Index

2018 Clinical nutrition (Edinburgh, Scotland)

5. Adequacy of nutrition and body weight in patients with early stage dementia: The cognition and aging study. (PubMed)

independent factor related to both MNA-SF (β = -.06, P < 0.001) and MNA (β = -.1, P < 0.001). A BMI of 22-23 kg/m2 was adequate in this group of patients with early stage dementia from nutritional and comorbidity perspectives. After controlling for BMI, the patients with advanced dementia had higher swallowing problem and appetite change scores.In these patients with early stage dementia, a higher BMI indicated adequate nutritional status and higher MMSE, but also higher rates of comorbidities, diabetes (...) Adequacy of nutrition and body weight in patients with early stage dementia: The cognition and aging study. Recent evidence highlights the effects of obesity, diabetes and hypertension in the development of Alzheimer's disease. Involuntary body weight changes in patients with different stages of dementia can be related to clinical factors of the patient per se or support from their caregivers. Understanding the interactions among factors is important to establish a monitoring paradigm to guide

2018 Clinical nutrition (Edinburgh, Scotland)

6. A Systematic Review of Intervention Studies Examining Nutritional and Herbal Therapies for Mild Cognitive Impairment and Dementia Using Neuroimaging Methods: Study Characteristics and Intervention Efficacy. (PubMed)

A Systematic Review of Intervention Studies Examining Nutritional and Herbal Therapies for Mild Cognitive Impairment and Dementia Using Neuroimaging Methods: Study Characteristics and Intervention Efficacy. Neuroimaging facilitates the assessment of complementary medicines (CMs) by providing a noninvasive insight into their mechanisms of action in the human brain. This is important for identifying the potential treatment options for target disease cohorts with complex pathophysiologies. The aim (...) of this systematic review was to evaluate study characteristics, intervention efficacy, and the structural and functional neuroimaging methods used in research assessing nutritional and herbal medicines for mild cognitive impairment (MCI) and dementia. Six databases were searched for articles reporting on CMs, dementia, and neuroimaging methods. Data were extracted from 21/2,742 eligible full text articles and risk of bias was assessed. Nine studies examined people with Alzheimer's disease, 7 MCI, 4 vascular

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2017 Evidence-based Complementary and Alternative Medicine : eCAM

7. Tube-Feeding in US Nursing Home Residents with Advanced Dementia, 2000–2014 (PubMed)

Tube-Feeding in US Nursing Home Residents with Advanced Dementia, 2000–2014 27533163 2016 09 13 2018 12 02 1538-3598 316 7 2016 Aug 16 JAMA JAMA Tube Feeding in US Nursing Home Residents With Advanced Dementia, 2000-2014. 769-70 10.1001/jama.2016.9374 Mitchell Susan L SL Hebrew SeniorLife Institute for Aging Research, Harvard Medical School, Boston, Massachusetts. Mor Vincent V Center for Gerontology and Health Care Research, Brown University, Providence, Rhode Island. Gozalo Pedro L PL (...) , N.I.H., Extramural United States JAMA 7501160 0098-7484 AIM IM African Continental Ancestry Group statistics & numerical data Aged, 80 and over Dementia ethnology Enteral Nutrition statistics & numerical data trends Female Humans Male Nursing Homes statistics & numerical data Poisson Distribution Regression Analysis Time Factors United States 2016 8 18 6 0 2016 8 18 6 0 2016 9 14 6 0 ppublish 27533163 2544627 10.1001/jama.2016.9374 PMC4991625 NIHMS797122 J Am Geriatr Soc. 2012 Oct;60(10):1918-21

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2016 JAMA

8. The impact of Nursing Homes staff education on end-of-life care in residents with advanced dementia: a quality improvement study. (PubMed)

The impact of Nursing Homes staff education on end-of-life care in residents with advanced dementia: a quality improvement study. End-of-life care in nursing homes (NHs) needs improvement. We carried out a study in 29 NHs in the Lombardy Region (Italy).The objective of this study was to compare end-of-life care in NH residents with advanced dementia before and after an educational intervention aimed to improving palliative care.The intervention consisted of a seven-hour lecture, followed by two (...) 3-hour meetings consisting of case discussions. The intervention was held in each NH and well attended by NH staff. This multicenter, comparative, observational study included up to 20 residents with advanced dementia from each NH: the last 10 who died before the intervention (preintervention group, 245 residents) and the first 10 who died at least three months after the intervention (postintervention group, 237 residents). Data for these residents were collected from records for 60 days

2018 Journal of pain and symptom management

9. Medical Advance Directive: An Emphatic "NO!" to Dementia

Medical Advance Directive: An Emphatic "NO!" to Dementia Bioethics Discussion Blog: Medical Advance Directive: An Emphatic "NO!" to Dementia What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact (...) OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice FEEDBACK,FEEDBACK,FEEDBACK! WRITE YOUR FEEDBACK ABOUT THIS BLOG, WHAT IS GOOD, POOR AND CONSTRUCTIVE SUGGESTIONS FOR IMPROVEMENT TO THIS Sunday, November 12, 2017 Medical Advance Directive: An Emphatic "NO!" to Dementia Norman Cantor, a lawyer and Professor of Law at Rutgers University School of Law wrote a thoughtful article about

2017 Bioethics Discussion Blog

10. End-of-life issues in advanced dementia: Part 2: management of poor nutritional intake, dehydration, and pneumonia (PubMed)

End-of-life issues in advanced dementia: Part 2: management of poor nutritional intake, dehydration, and pneumonia To answer frequently asked questions about management of end-stage pneumonia, poor nutritional intake, and dehydration in advanced dementia.Ovid MEDLINE was searched for relevant articles published until February 2015. No level I studies were identified; most articles provided level III evidence. The symptom management suggestions are partially based on recent participation (...) in a Delphi procedure to develop a guideline for optimal symptom relief for patients with pneumonia and dementia.Feeding tubes are not recommended for patients with end-stage dementia. Comfort feeding by hand is preferable. Use of parenteral hydration might be helpful but can also contribute to discomfort at the end of life. Withholding or withdrawing artificial nutrition and hydration is generally not associated with manifestations of discomfort if mouth care is adequate. Because pneumonia usually causes

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2015 Canadian Family Physician

11. Outcomes of enteral nutrition for patients with advanced dementia: a systematic review. (PubMed)

Outcomes of enteral nutrition for patients with advanced dementia: a systematic review. The present article aims to evaluate the outcomes of enteral nutrition for people with advanced dementia. A systematic review was conducted by searching The Cochrane Library, MEDLINE, EMBASE, PROQUEST and LILACS for articles that were published from 2008 to 2013. Prospective and retrospective studies involving a control group were searched. Data were independently extracted and assessed by one reviewer (...) and checked by a second. Searched outcomes included survival, clinical and nutritional parameters and complications. In total, nine controlled studies were identified from several parts of the world: Israel, Italy, Japan, the United States and Brazil. Most of the studies did not report any outcome of harm with enteral nutrition use in dementia patients compared with patients without dementia. A study with a higher follow-up period demonstrated improvements in albumin, weight and chronic inflammation

2015 The journal of nutrition, health & aging

12. Artificial nutrition and hydration in advanced dementia (PubMed)

Artificial nutrition and hydration in advanced dementia 25767168 2016 02 01 2018 11 13 1715-5258 61 3 2015 Mar Canadian family physician Medecin de famille canadien Can Fam Physician Artificial nutrition and hydration in advanced dementia. 245-8, e125-8 Ying Irene I Palliative care consultant at Sunnybrook Health Sciences Centre in Toronto, Ont, Assistant Professor in the Department of Family and Community Medicine at the University of Toronto, and a member of the Joint Centre for Bioethics (...) at the University of Toronto. eng fre Journal Article Canada Can Fam Physician 0120300 0008-350X IM Aged, 80 and over Alzheimer Disease nursing Enteral Nutrition adverse effects ethics psychology Female Health Knowledge, Attitudes, Practice Humans Hypodermoclysis adverse effects ethics psychology 2015 3 14 6 0 2015 3 15 6 0 2016 2 2 6 0 ppublish 25767168 61/3/245 PMC4369630 Care Manag J. 2006 Summer;7(2):79-85 17214240 Dysphagia. 1996 Spring;11(2):104-9 8721068 JAMA. 1999 Oct 13;282(14):1365-70 10527184 N Engl

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2015 Canadian Family Physician

13. Specialist dementia care units

Specialist dementia care units Specialist dementia care units An Evidence Check rapid review brokered by the Sax Institute for the Commonwealth Department of Health. September 2017 An Evidence Check rapid review brokered by the Sax Institute for the Commonwealth Department of Health. September 2017. This report was prepared by: Malcolm Masso, Cathy Duncan, Pam Grootemaat, Lyn Phillipson, Peter Samsa, Dave Fildes and Rob Gordon. Australian Health Services Research Institute, University (...) www.saxinstitute.org.au knowledge.exchange@saxinstitute.org.au Phone: +61 2 91889500 Suggested Citation: Masso M, Duncan C, Grootematt P, Phillipson L, Samsa P, Fildes D, Gordon R. Specialist dementia care units: an Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Commonwealth Department of Health, 2017. Disclaimer: This Evidence Check Review was produced using the Evidence Check methodology in response to specific questions from the commissioning agency

2018 Sax Institute Evidence Check

14. Peri-operative care of people with dementia

Peri-operative care of people with dementia Guidelines Peri-operative care of people with dementia February 2019Guidelines Guidelinesfortheperi-operativecareofpeoplewithdementia GuidelinesfromtheAssociationofAnaesthetists S.White, 1 R.Grif?ths, 2 M.Baxter, 3 T.Beanland, 4 J.Cross, 5 J.Dhesi, 6 A.B.Docherty, 7 I.Foo, 8 G.Jolly, 9 J.Jones, 10 I.K.Moppett, 11 E.Plunkett 12 andK.Sachdev 13 1ConsultantAnaesthetist,RoyalSussexCountyHospital,Brighton,UKandco-Chair,AssociationofAnaesthetists (...) 13ConsultantinOlderAdultPsychiatry,HomertonUniversityHospitalNHSFoundationTrust,London,UK Summary Ageing populations have greater incidences of dementia. People with dementia present for emergency and, increasingly, elective surgery, but are poorly served by the lack of available guidance on their peri-operative management, particularly relating to pharmacological, medico-legal, environmental and attitudinal considerations. These guidelines seek to deliver such guidance, by providing information for peri-operative care

2019 Association of Anaesthetists of GB and Ireland

15. Is tube feeding futile in advanced dementia? (PubMed)

Is tube feeding futile in advanced dementia? It is controversial whether tube feeding in people with dementia improves nutritional status or prolongs survival. Guidelines published by several professional societies cite observational studies that have shown no benefit and conclude that tube feeding in patients with advanced dementia should be avoided. However, all studies on tube feeding in dementia have major methodological flaws that invalidate their findings. The present evidence (...) is not sufficient to justify general guidelines. Patients with advanced dementia represent a very heterogeneous group, and evidence demonstrates that some patients with dementia benefit from tube feeding. However, presently available guidelines make a single recommendation against tube feeding for all patients. Clinicians, patients, and surrogates should be aware that the guidelines and prior commentary on this topic tend both to overestimate the strength of evidence for futility and to exaggerate the burdens

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2016 The Linacre Quarterly

16. Fasting and Nutritional Therapy in Patients With Advanced Metastatic Prostate Cancer

Fasting and Nutritional Therapy in Patients With Advanced Metastatic Prostate Cancer Fasting and Nutritional Therapy in Patients With Advanced Metastatic Prostate Cancer - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before (...) adding more. Fasting and Nutritional Therapy in Patients With Advanced Metastatic Prostate Cancer The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT02710721 Recruitment Status : Recruiting First Posted : March 17, 2016 Last

2016 Clinical Trials

17. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutritio

Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutritio Copyright © ESPGHAN and NASPGHAN. All rights reserved. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (...) and the European Society forPediatricGastroenterology,Hepatology,andNutrition Rachel Rosen, y Yvan Vandenplas, z Maartje Singendonk, § Michael Cabana, jj Carlo DiLorenzo, Frederic Gottrand, # Sandeep Gupta, Miranda Langendam, yy Annamaria Staiano, zz Nikhil Thapar, §§ Neelesh Tipnis, and z Merit Tabbers ABSTRACT This document serves as an update of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology

2018 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

18. Clinical practice guidelines and principles of care for people with dementia

with the person with dementia, while he or she still has capacity, and his or her carer(s) and family the use of: - an Enduring Power of Attorney and enduring guardianship - Advance Care Plans. Advance Care Plans should be revisited with the person with dementia and his or her carer(s) and family on a regular basis and following any significant change in health condition or circumstance. Advance Care Plans should be completed or updated at the time of assessment undertaken by the Aged Care Assessment Team. 7 (...) should have their weight monitored and nutritional status assessed regularly. In cases of undernutrition, consultation with a dietitian and/or assessment by a speech pathologist may be indicated. 65 PP Dental and oral health personnel are an integral part of the health care team for people with dementia. Upon diagnosis, the medical practitioner should recommend the person with dementia (or their carer(s) or family) makes an appointment to see a dentist. The dentist should conduct an assessment

2016 Clinical Practice Guidelines Portal

19. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

patient care by advancing the science and practice of clinical nutrition and metabolism. The mission of SCCM is to secure the highest quality care for all critically ill and injured patients. Guideline Limitations : These A.S.P.E.N.−SCCM Clinical Guidelines are based on general conclusions of health professionals who, in developing such guidelines, have balanced potential benefits to be derived from a particular mode of medical therapy against certain risks inherent with such therapy. However (...) (PN) by central venous access. Standard therapy (STD ) refers to provision of IV fluids, no EN or PN, and advancement to oral diet as tolerated. | INTRODUCTION The significance of nutrition in the hospital setting (and especially the ICU) cannot be overstated. Critical illness is typically associated with a catabolic stress state in which patients demonstrate a systemic inflammatory response coupled with complications of increased infectious morbidity, multiple organ dysfunction, prolonged

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2016 Society of Critical Care Medicine

20. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

. Standard therapy (STD) refers to provision of intravenous (IV) fluids, no EN or PN, and advancement to oral diet as tolerated. Introduction The significance of nutrition in the hospital setting (especially the ICU) cannot be overstated. Critical illness is typically associated with a catabolic stress state in which patients demonstrate a systemic inflammatory response coupled with complications of increased infectious morbidity, multiple‐organ dysfunction, prolonged hospitalization (...) , and disproportionate mortality. Over the past 3 decades, exponential advances have been made in the understanding of the molecular and biological effects of nutrients in maintaining homeostasis in the critically ill population. Traditionally, nutrition support in the critically ill population was regarded as adjunctive care designed to provide exogenous fuels to preserve lean body mass and support the patient throughout the stress response. Recently, this strategy has evolved to represent nutrition therapy

2016 American Society for Parenteral and Enteral Nutrition

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