Diet Modifications
- 5-6 is mechanical soft diet
- 4 – pureed. involves very little mastication. Very thick.
- 1 – slightly thick = ensure etc…
Feeding Facts
- NPO does not prevent G tube feedings, gastric contents, or secretions.
- Tube feedings are a higher predictor of aspiration pneumonia than dysphagia.
- Thickened liquids can still be aspirated and can lead to dehydration.
- Expensive
- dehydration
- constipation
- fecal impactions
- No good evidence that thickening liquids reduces aspiration.
- Aspiration is more common with thinner diet and liquids.
- Studies indicate that modified diets reduce quality of life.
Oropharyngeal Dysphagia
- Goal is likely to be eating for pleasure
- Modification of food often leads to reduced intake and dehydration and malnutriton
Dementia
- Hand feeding rather than tube feeding is prefered.
- Low quality evidence that appetite simulants, assisted feeding, and modified foods lead to weight gain.
- Moderate quality evidence that high-calorie supplements lead to weight gain.
- Most advanced dementia paitent will have difficulty eating in the final stages.
- Tube feeds to not improve QOL or reduce mortality. It doesn’t matter if you put it in early or late in the dementia process.
- Tube feeds do not reduce aspiration, pressure ulcers, wounds, or nutritional status.
- Tube feeds increase hospitalizations for no improvement in QOL
- Tube feeds increase the likelihood of developing a pressure ulcer 2.3x