EBP Compendium: Summary of Clinical Practice Guideline
The Alzheimer's Association
Dementia Care Practice Recommendations for Assisted Living Residences and Nursing Homes: Phase 3 End-of-Life Care
Tilly, J., Reed, P., et. al.
Chicago (IL): The Alzheimer's Association, 28 pages.
AGREE Rating: Recommended with Provisos
This guideline provides recommendations for the management of individuals with dementia nearing the end of life. The target audience of this guideline includes all healthcare professionals involved in the management of individuals with dementia. Recommendations of relevance to speech-language pathologists include end of life nutrition.
General Findings - The residents' desires, culture and religion should be considered along with their current functional status when making decisions about end-of-life care. Examples include "residents who cannot swallow and who suffer from repeated bouts with aspiration pneumonia may not be responsive to or benefit from yet another course of antibiotics" (p. 14).
Diet Modification - Dietary restrictions may be modified when residents have difficulty swallowing or are not eating enough to maintain their weight.
Tube Feeding - "[R]esidents who cannot swallow may not benefit from artificial nutrition and hydration because these treatments may cause discomfort and increase the potential for aspiration" (p. 14).
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Added to Compendium: November 2010