Palliative Care Resources

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Clinical Presentations
Improving Decision-Making about Feeding Options in Dementia
Feeding problems are common in advanced dementia, triggering decision-making about options of tube feeding, assisted oral feeding, and feeding for comfort only. Shared decision-making is the desired ethical standard for treatment decisions with uncertain benefit, but it is rare for tube feeding. Decision aids provide structured information about a clinical choice, including clear delineation of options, presented with the pros and cons, and guidance for how to make a choice. Content is purposefully balanced and evidence-based. In the Improving Decision Making about Feeding Options in Dementia study, a team of investigators developed and tested a decision aid for surrogate decision-makers for patients with advanced dementia, and found it effective to improve knowledge, reduce decisional conflict and increase communication about feeding options with providers. The Improving Decision Making about Feeding Options in Dementia study was funded by the National Institutes of Health: National Institute for Nursing Research R01 NR009826. The funding source had no role in the design and conduct of the research, and does not directly endorse the decision aid.