Eating dying and patients with severe dementia

Anorexia or loss of appetite is often found among dying patients. Behavioral approaches (for example, a flexible meal schedule, slow feeding, small portions, favorite or very fragrant dishes) often increase food intake through the mouth. It can also be helped by taking small amounts of your favorite alcoholic drink 30 minutes before meals. Can stimulate the appetite and certain antidepressants: megestrol acetate and dronabinol. Metoclopramide strengthens the emptying of the stomach, which can also increase appetite, but it may take 1-2 weeks to achieve peak efficacy.

Progressive dementia, ultimately, leads to the inability to eat by the patients themselves; sometimes such patients are fed through a probe. However, there is no conclusive evidence that feeding with a probe prolongs life, provides comfort, improves functions or prevents complications (aspiration, pressure sores).

Feeding through the probe and parenteral nutrition causes inconvenience and is usually not prescribed to dying patients or patients with severe dementia who are unable to eat. It is difficult for family members to agree with the refusal of parenteral nutrition, but they should understand that for those patients, those food and drink that they themselves choose are more pleasant. Small sips of water and easy-to-swallow food products can be helpful. Supportive care, including good oral hygiene (brushing teeth, moistening the mouth with tampons and ice slices if necessary, lip liner) can physically and psychologically calm the patient and family members who provide this care. Family members who are worried about the need to use invasive parenteral nutrition are helped by the advice and recommendations of specialists.

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