The Efficacy and Safety of Tube Feeding in Advanced Dementia Patients: A Systemic Review and Meta-Analysis Study

Lee, Yen-Feng; Hsu, Tien‐Wei; Liang, Chih‐Sung; Yeh, Ta‐Chuan; Chen, Tien‐Yu; Chen, Nai-Ching; Chu, Che‐Sheng

doi:10.1016/j.jamda.2020.06.035

Cited by 50 publications

(27 citation statements)

References 33 publications

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“…From this screening process, we included 32 articles. During the screening, we identified two review papers that had information about PIs in PLWD (Lee et al, 2021; Parker et al, 2020). We examined the articles within those reviews and included four publications that aligned with our inclusion criteria (Arinzon et al, 2008; Luo et al, 2010; Mitchell et al, 2010; Peck et al, 1990).…”

Section: Resultsmentioning

confidence: 99%

Chronic wounds in persons living with dementia: An integrative review

Sefcik

McLaurin

Bass

et al. 2022

Int J Older People Nursing

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Background: Persons living with dementia (PLWD) are at risk for chronic wounds; however, they are rarely included in research.Objectives: To inform practice and research directions, the aim of this integrative review was to identify and synthesise previous knowledge about the characteristics of chronic wounds in PLWD, in terms of chronic wound types, prevalence, setting and interventions.Design: A literature search was conducted for publications in English using PubMed, Web of Science and CINAHL. The minimum information required for inclusion was how many PLWD enrolled in the study had wounds.Methods: This integrative review followed the Whittemore and Knafl methodology.Data extraction and synthesis were guided by a directed content analysis, with a coding structure based on an initial review of the literature.Results: Thirty-six articles met the inclusion criteria. The majority were missing characteristics of PLWD including severity of dementia and race/ethnicity/nationality, and none mentioned skin tone. Most focused on pressure injuries in the nursing home and acute care setting. Few included information on interventions. Only one discussed challenges of wound care for a PLWD exhibiting aggression. Conclusion:There is a gap in the literature regarding PLWD and chronic wounds other than pressure injuries that are common in older adults (e.g. diabetic foot ulcers, venous leg ulcers). Research is warranted among those PLWD who live alone and those who receive wound care from family caregivers to understand experiences. Knowledge can inform the development of future novel interventions for wound healing. Future research is needed regarding chronic wounds in those who exhibit behavioural and psychological symptoms of dementia.Relevance to Clinical Practice: Nurses that care for chronic wounds in PLWD can contribute their knowledge to include information in guidelines on best care practices and contribute their perspective to research teams for future research.

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Section: Resultsmentioning

confidence: 99%

Chronic wounds in persons living with dementia: An integrative review

Sefcik

McLaurin

Bass

et al. 2022

Int J Older People Nursing

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“…A literatura evidencia e publicações de associações e sociedades médicas não recomendam o uso de sondas de alimentação em pacientes portadores de demência avançada, seja pela ausência de benefícios em vários desfechos em saúde como aumento de sobrevida, prevenção de pneumonia aspirativa 27,28 . Em recente revisão sistemática, publicada por Lee 29 , observouse que alimentação por sonda está associada com aumento da taxa de mortalidade e possíveis complicações relacionadas ao tubo, a ausência de melhora na sobrevida e do estado nutricional.…”

Section: Resultsunclassified

Palliative care and advanced dementia: trajectory of hospitalized elderly people in their last 48 hours of life

et al. 2021

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Analisar as últimas 48h de vida de idosos com demência avançada hospitalizados e o perfil de cuidados ao longo dos 5 anos analisados. Trata-se de um estudo transversal retrospectivo, através da análise de prontuários eletrônicos dos pacientes participantes do estudo, e que foram a óbito entre 01 janeiro de 2013 e 31 de dezembro de 2017. Foram analisados 328 prontuários no período definido e 97 preencheram os critérios de inclusão. Noventa e três pacientes (95,9%) tiveram registro de diretrizes antecipadas de vontade, 73,2% eram do sexo feminino, com idade média de 88,7 anos, 52,6% dos óbitos ocorreram em apartamento ou enfermaria, nas últimas 48h de vida, 64,9% estavam com dieta por sonda, 28,9% respirando com assistência ventilatória mecânica, 51% usando antibiótico, 86,6% com prescrição de analgesia fixa, contudo 19% tinham registro de dor não controlada. Ao longo dos 5 anos de observação, houve mudanças nos seguintes aspectos: redução de óbitos na unidade de terapia intensiva (60% x 36,4%), diminuição do uso de dieta por sondas (87% x 32%), do uso de assistência ventilatória mecânica (53% x 18%); do uso de cateter venoso central (47% x 27%); do uso de sonda vesical de demora (27% x 5%), e da presença de lesão por pressão (87% x 45%). Conclui-se que nos 5 anos de análise, uma tendência paliativista na assistência, caracterizada pela redução de procedimentos considerados invasivos, nas últimas 48h de vida, em pacientes com demência avançada.

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“…However, tube feeding in patients with advanced dementia increased mortality and tube-related complications, such as pneumonia, but did not improve survival and nutritional status. 23,50 Therefore, we recommend the use of nasogastric tubes and gastrostomy as a means of meeting nutritional requirements to improve the QOL, by promoting oral intake in patients with dysphagia. However, artificial nutrition, including enteral nutrition, requires invasive procedures; hence, medical indications and patient and family wishes must be considered when deciding to undergo such procedures.…”

Section: Comprehensive Interventionmentioning

confidence: 99%