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
- Aspiration Pneumonia prophylaxis (unproven)
- Malnutrition (unproven)
- Pressure Ulcer reduction (unproven)
- Improved survival and function (unproven)
III. General measures to improve food intake
- See Dysphagia Diet for possible limitations
- Strong flavors should be used
- Serve foods either hot or cold (not tepid)
- Enhance flavor with spice, gravy, juice, cream
- Offer preferred foods without restriction
- Ice cream
- Miniature chocolate bars
- Consider liquid supplements (e.g. Ensure, Boost)
- Avoid near meal time (avoid within 2 hours of meal)
- Consider alternatives to commercial supplements
- Milkshakes
- Blended food (e.g. cereal in eggnog)
- Patient should have easy access to food
- Mealtime duration may need to be lengthened
- Place finger foods, candy bars, liquids at bedside
- Create No-fail Environment in Dementia
- Provide meals at midday at maximal cognitive function
- Reduce Agitation in patients
- Hold hands or gently touch
- Talk about pleasant topics or sing softly
