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2 results

  • Chapter 19 - Eating and Drinking Difficulties

  • Edited by David M. L. Branford, Independent Pharmacy Consultant, Satheesh K. Gangadharan, Leicestershire Partnership NHS Trust, Mary Barrett, Leicestershire Partnership NHS Trust, Regi T. Alexander, Hertfordshire Partnership University NHS Foundation Trust
  • Book:
    The Frith Prescribing Guidelines for People with Intellectual Disability
    Published online:
    07 November 2024
    Print publication:
    21 November 2024, pp 275-296

  • Summary

    Eating and drinking difficulties are highly prevalent in the intellectual disability population and include all aspects of the eating and drinking process. This can include stable positioning and pacing the meal all the way through to safe swallowing. Dysphagia is a subset of wider eating and drinking difficulties, often seen in the intellectual disability population. Dysphagia presents as a difficulty chewing and swallowing. It is often the underlying cause of malnutrition, dehydration, weight loss, choking, and aspiration pneumonia, with risks to mental health, social isolation, dignity, and enjoyment. A deterioration in eating and drinking skills is often a symptom of a broader physical and mental health diagnosis. People with eating and drinking difficulties can also experience a cyclical decline in health and an increased risk of malnutrition and dehydration. In addition to eating and drinking difficulties this chapter covers surgical intervention requiring insertion of a gastric tube, the impact of medication on feeding, and strategies to manage eating and drinking difficulties.

  • Artificial nutrition and hydration at the end of life: Ethics and evidence

  • LINDA GANZINI
  • Journal:
    Palliative & Supportive Care / Volume 4 / Issue 2 / June 2006
    Published online by Cambridge University Press:
    09 August 2006, pp. 135-143

  • The case of Terri Schiavo resulted in substantial media attention about the use of artificial nutrition and hydration (ANH) especially by percutaneous endoscopic gastrostomy (PEG). In this article, I review ethical and legal principles governing decisions to choose or forgo ANH at the end of life, including issues of autonomy and decision-making capacity, similarities and differences between ANH and other medical treatments, the role of proxies when patients lack decision-making capacity, and the equivalence of withholding and withdrawing treatment. Evidence for palliative or life-sustaining benefits for ANH are reviewed in three disease processes: amyotrophic lateral sclerosis (ALS), cancer, and dementias, including Alzheimer's disease. Although more recent studies suggest a possible palliative role for ANH in ALS and terminal cancer, feeding tubes do not appear to prolong survival or increase comfort in advanced dementia of the Alzheimer's type.