Comfort feeding in hospitalised people with dementia: a retrospective study of survival following comfort feeding recommendations
Objectives: Persistent and significant swallowing impairment can occur in individuals with dementia. Determining prognosis and establishing realistic goals of care in this population is complex and comfort feeding may be recommended. This study aimed to establish evidence relating to patient outcome...
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Elsevier
2024-10-01
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| Series: | The Journal of Nutrition, Health and Aging |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1279770724004494 |
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| author | Christine Davis Nasime Mokari-Manshadi Viviane De Menezes Caceres Patrick Russell Toby Gilbert Stephen Hedger Udul Hewage Dirk Hoffman Yogesh Sharma Alice O’Connell Amrit Sandhu Jeff Faunt Campbell Thompson |
| author_facet | Christine Davis Nasime Mokari-Manshadi Viviane De Menezes Caceres Patrick Russell Toby Gilbert Stephen Hedger Udul Hewage Dirk Hoffman Yogesh Sharma Alice O’Connell Amrit Sandhu Jeff Faunt Campbell Thompson |
| author_sort | Christine Davis |
| collection | DOAJ |
| description | Objectives: Persistent and significant swallowing impairment can occur in individuals with dementia. Determining prognosis and establishing realistic goals of care in this population is complex and comfort feeding may be recommended. This study aimed to establish evidence relating to patient outcomes following recommendation of comfort feeding to aid informed decision making. Design: A multi-centre, retrospective audit was conducted for a two-year period to establish the survival and readmission rates for hospitalised people with dementia, following recommendation of a comfort feeding plan. Setting: The study was conducted at three acute care hospitals in Adelaide, South Australia. Participants: A total of 163 participants were included, 90 male and 73 female, with a median age of 88 years. Measurements: Mortality within 30 and 90 days of admission and readmission rates within 30 days of discharge were calculated. Results: Forty-two percent of participants died during the admission during which a comfort feeding plan was recommended. Overall median survival time and one month survival was 13 days and 25%, respectively. Readmission rates were low (7.4% of those discharged). Comfort feeding recommendations aligned with dysphagia severity and those for whom Nil By Mouth (NBM) or ice chips only were recommended were at highest risk of dying in hospital, those recommended thickened fluids +/− ice chips were most likely to be alive 30 days after their original admission date. Conclusion: Dementia and comfort feeding were associated with high mortality rates, high rates of discharge to a supportive care facility and low readmission rates. Dysphagia severity associated with the consistency of fluids recommended. |
| format | Article |
| id | doaj-art-38f8bc979eee43acb74e88e1647a6556 |
| institution | OA Journals |
| issn | 1760-4788 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Journal of Nutrition, Health and Aging |
| spelling | doaj-art-38f8bc979eee43acb74e88e1647a65562025-08-20T02:15:12ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882024-10-01281010036210.1016/j.jnha.2024.100362Comfort feeding in hospitalised people with dementia: a retrospective study of survival following comfort feeding recommendationsChristine Davis0Nasime Mokari-Manshadi1Viviane De Menezes Caceres2Patrick Russell3Toby Gilbert4Stephen Hedger5Udul Hewage6Dirk Hoffman7Yogesh Sharma8Alice O’Connell9Amrit Sandhu10Jeff Faunt11Campbell Thompson12Department of Speech Pathology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, 5000, Australia; Corresponding author.Department of Speech Pathology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, South Australia, 5042, AustraliaSchool of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, 5005, AustraliaDepartment of Internal Medicine, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, 5000, AustraliaDiscipline of Medicine, The University of Adelaide, 5000, Adelaide, South Australia, AustraliaDepartment of Internal Medicine Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, South Australia, 5042, AustraliaDepartment of Internal Medicine Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, South Australia, 5042, AustraliaDepartment of General Internal Medicine, Noarlunga Hospital, Southern Adelaide Local Health Network, Adelaide, 5168, South Australia, AustraliaDepartment of Internal Medicine Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, South Australia, 5042, Australia; College of Medicine & Public Health, Flinders University, 5042, Adelaide, South Australia, AustraliaDepartment of Internal Medicine, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, 5000, AustraliaDepartment of Internal Medicine, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, 5000, AustraliaDepartment of Internal Medicine, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, 5000, AustraliaDiscipline of Medicine, The University of Adelaide, 5000, Adelaide, South Australia, AustraliaObjectives: Persistent and significant swallowing impairment can occur in individuals with dementia. Determining prognosis and establishing realistic goals of care in this population is complex and comfort feeding may be recommended. This study aimed to establish evidence relating to patient outcomes following recommendation of comfort feeding to aid informed decision making. Design: A multi-centre, retrospective audit was conducted for a two-year period to establish the survival and readmission rates for hospitalised people with dementia, following recommendation of a comfort feeding plan. Setting: The study was conducted at three acute care hospitals in Adelaide, South Australia. Participants: A total of 163 participants were included, 90 male and 73 female, with a median age of 88 years. Measurements: Mortality within 30 and 90 days of admission and readmission rates within 30 days of discharge were calculated. Results: Forty-two percent of participants died during the admission during which a comfort feeding plan was recommended. Overall median survival time and one month survival was 13 days and 25%, respectively. Readmission rates were low (7.4% of those discharged). Comfort feeding recommendations aligned with dysphagia severity and those for whom Nil By Mouth (NBM) or ice chips only were recommended were at highest risk of dying in hospital, those recommended thickened fluids +/− ice chips were most likely to be alive 30 days after their original admission date. Conclusion: Dementia and comfort feeding were associated with high mortality rates, high rates of discharge to a supportive care facility and low readmission rates. Dysphagia severity associated with the consistency of fluids recommended.http://www.sciencedirect.com/science/article/pii/S1279770724004494Comfort feedingDementiaDysphagiaMortalitySurvival |
| spellingShingle | Christine Davis Nasime Mokari-Manshadi Viviane De Menezes Caceres Patrick Russell Toby Gilbert Stephen Hedger Udul Hewage Dirk Hoffman Yogesh Sharma Alice O’Connell Amrit Sandhu Jeff Faunt Campbell Thompson Comfort feeding in hospitalised people with dementia: a retrospective study of survival following comfort feeding recommendations The Journal of Nutrition, Health and Aging Comfort feeding Dementia Dysphagia Mortality Survival |
| title | Comfort feeding in hospitalised people with dementia: a retrospective study of survival following comfort feeding recommendations |
| title_full | Comfort feeding in hospitalised people with dementia: a retrospective study of survival following comfort feeding recommendations |
| title_fullStr | Comfort feeding in hospitalised people with dementia: a retrospective study of survival following comfort feeding recommendations |
| title_full_unstemmed | Comfort feeding in hospitalised people with dementia: a retrospective study of survival following comfort feeding recommendations |
| title_short | Comfort feeding in hospitalised people with dementia: a retrospective study of survival following comfort feeding recommendations |
| title_sort | comfort feeding in hospitalised people with dementia a retrospective study of survival following comfort feeding recommendations |
| topic | Comfort feeding Dementia Dysphagia Mortality Survival |
| url | http://www.sciencedirect.com/science/article/pii/S1279770724004494 |
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