Assisted feeding

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A nurse assisting a patient. 1941 An American Nurse in Britain- the work of Sister Trotter at Park Prewett Hospital, Basingstoke, England, 1941 D3021.jpg
A nurse assisting a patient. 1941

Assisted feeding, also called hand feeding or oral feeding, is the action of a person feeding another person who cannot otherwise feed themselves. The term is used in the context of some medical issue or in response to a disability, such as when a person living with dementia is no longer able to manage eating alone. The person being fed must be able to eat by mouth, but lacks either the cognitive or physical ability to self-feed. Individuals who are born with a disability like cerebral palsy, or arthrogryposis multiplex congenita (AMC) may be unable to feed themselves. Also, those who acquire a disability due to an accident or a disease like amyotrophic lateral sclerosis (ALS) may require hand feeding because they may become unable to pick-up and bring food to their own mouth. Guidance about safely assisting people to eat can be found at the Feeding the Disabled website.

Contents

Also there are devices available that many people who cannot feed themselves can use to give them control over their eating. Please refer to the Wikipedia topic “Assistive eating devices” for information about these devices.

Assisted feeding as an alternative to tube feeding

A feeding tube is a medical device used to provide nutrition to patients who cannot obtain nutrition by mouth, are unable to swallow safely, or need nutritional supplementation. [1] Patients who are able to use assisted feeding should have that in preference to tube feeding whenever possible. [1]

Oral assisted feedings are preferable to percutaneous feeding in individuals with advanced dementia. [2]

Monetary costs

In the United States a study reviewed a set of patients and found that the expenses to arrange assisted feeding for patients was higher than the cost of using a feeding tube. [3]

Related Research Articles

Assistive technology Assistive devices for people with disabilities

Assistive technology (AT) is a term for assistive, adaptive, and rehabilitative devices for people with disabilities or the elderly population. People with disabilities often have difficulty performing activities of daily living (ADLs) independently, or even with assistance. ADLs are self-care activities that include toileting, mobility (ambulation), eating, bathing, dressing, grooming, and personal device care. Assistive technology can ameliorate the effects of disabilities that limit the ability to perform ADLs. Assistive technology promotes greater independence by enabling people to perform tasks they were formerly unable to accomplish, or had great difficulty accomplishing, by providing enhancements to, or changing methods of interacting with, the technology needed to accomplish such tasks. For example, wheelchairs provide independent mobility for those who cannot walk, while assistive eating devices can enable people who cannot feed themselves to do so. Due to assistive technology, people with disability have an opportunity of a more positive and easygoing lifestyle, with an increase in "social participation," "security and control," and a greater chance to "reduce institutional costs without significantly increasing household expenses."

Dementia Long-term brain disorders causing impaired memory, thinking and behavior

Dementia manifests as a set of related symptoms, which usually surface when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively impact a person's ability to function and carry out everyday activities. Aside from memory impairment and a disruption in thought patterns, the most common symptoms include emotional problems, difficulties with language, and decreased motivation. The symptoms may be described as occurring in a continuum over several stages. Dementia is not a disorder of consciousness, as that is not usually affected. It ultimately has a significant effect on the individual, caregivers, and relationships in general.

Anorexia (symptom) Medical symptom

Anorexia is a medical term for a loss of appetite. While the term in non-scientific publications is often used interchangeably with anorexia nervosa, many possible causes exist for a loss of appetite, some of which may be harmless, while others indicate a serious clinical condition or pose a significant risk.

A medical emergency is an acute injury or illness that poses an immediate risk to a person's life or long-term health, sometimes referred to as a situation risking "life or limb". These emergencies may require assistance from another, qualified person, as some of these emergencies, such as cardiovascular (heart), respiratory, and gastrointestinal cannot be dealt with by the victim themselves. Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, from first aiders through emergency medical technicians, paramedics, emergency physicians and anesthesiologists.

Choking Mechanical obstruction of the flow of air from the environment into the lungs

Choking, as foreign body airway obstruction (FBAO), is the fourth leading cause of unintentional injury death. It occurs when breathing is impeded by a constricted or obstructed throat or windpipe, resulting in oxygen deprivation. Although oxygen stored in the blood and lungs can keep a person alive for several minutes after breathing stops, choking often leads to death.

Intravenous therapy Medication administered into a vein

Intravenous therapy is a medical technique that delivers fluids, medications and nutrition directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutrition for those who cannot, or will not—due to reduced mental states or otherwise—consume food or water by mouth. It may also be used to administer medications or other medical therapy such as blood products or electrolytes to correct electrolyte imbalances. Attempts at providing intravenous therapy have been recorded as early as the 1400s, but the practice did not become widespread until the 1900s after the development of techniques for safe, effective use.

Dysphagia Medical condition

Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a condition in its own right.

Activities of daily living is a term used in healthcare to refer to people's daily self-care activities. Health professionals often use a person's ability or inability to perform ADLs as a measurement of their functional status. The concept of ADLs was originally proposed in the 1950s by Sidney Katz and his team at the Benjamin Rose Hospital in Cleveland, Ohio. The concept of ADLs has been added to and refined by a variety of researchers since that time. For example, many indexes that assess ADLs now include some measure of mobility. Additionally, to be more inclusive of the range of activities that support independent living, in 1969, Lawton and Brody developed the instrumental activities of daily living (IADLs). ADLs are often used in the care of people with disabilities, people with injuries, and the elderly. Younger children often require help from adults to perform ADLs, as they have not yet developed the skills necessary to perform them independently.

Life support

Life support refers to the treatments and techniques performed in an emergency in order to support life after the failure of one or more vital organs. Healthcare providers and emergency medical technicians are generally certified to perform basic and advanced life support procedures; however, basic life support is sometimes provided at the scene of an emergency by family members or bystanders before emergency services arrive. In the case of cardiac injuries, cardiopulmonary resuscitation is initiated by bystanders or family members 25% of the time. Basic life support techniques, such as performing CPR on a victim of cardiac arrest, can double or even triple that patient's chance of survival. Other types of basic life support include relief from choking, staunching of bleeding by direct compression and elevation above the heart, first aid, and the use of an automated external defibrillator.

Nasogastric intubation

Nasogastric intubation is a medical process involving the insertion of a plastic tube through the nose, past the throat, and down into the stomach. Orogastric intubation is a similar process involving the insertion of a plastic tube through the mouth. Abraham Louis Levin invented the NG tube. Nasogastric tube is also known as Ryle's tube in Commonwealth countries, after John Alfred Ryle.

Geriatrics Specialty that focuses on health care of elderly people

Geriatrics, or geriatric medicine, is a specialty that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults. There is no set age at which patients may be under the care of a geriatrician, or geriatric physician, a physician who specializes in the care of elderly people. Rather, this decision is determined by the individual patient's needs and the availability of a specialist. It is important to note the difference between geriatrics, the care of aged people and gerontology, which is the study of the aging process itself. The term geriatrics comes from the Greek γέρων geron meaning "old man", and ιατρός iatros meaning "healer". However, geriatrics is sometimes called medical gerontology.

Airway management Medical procedure ensuring an unobstructed airway

Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere. This is accomplished by either clearing a previously obstructed airway; or by preventing airway obstruction in cases such as anaphylaxis, the obtunded patient, or medical sedation. Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents (aspiration).

Feeding tube Medical device used to provide nutrition to people

A feeding tube is a medical device used to provide nutrition to people who cannot obtain nutrition by mouth, are unable to swallow safely, or need nutritional supplementation. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding. Placement may be temporary for the treatment of acute conditions or lifelong in the case of chronic disabilities. A variety of feeding tubes are used in medical practice. They are usually made of polyurethane or silicone. The diameter of a feeding tube is measured in French units. They are classified by the site of insertion and intended use.

Percutaneous endoscopic gastrostomy

Percutaneous endoscopic gastrostomy (PEG) is an endoscopic medical procedure in which a tube is passed into a patient's stomach through the abdominal wall, most commonly to provide a means of feeding when oral intake is not adequate. This provides enteral nutrition despite bypassing the mouth; enteral nutrition is generally preferable to parenteral nutrition. The PEG procedure is an alternative to open surgical gastrostomy insertion, and does not require a general anesthetic; mild sedation is typically used. PEG tubes may also be extended into the small intestine by passing a jejunal extension tube through the PEG tube and into the jejunum via the pylorus.

Aspiration pneumonia Medical condition

Aspiration pneumonia is a type of lung infection that is due to a relatively large amount of material from the stomach or mouth entering the lungs. Signs and symptoms often include fever and cough of relatively rapid onset. Complications may include lung abscess. Some include chemical induced inflammation of the lungs as a subtype, which occurs from acidic but non-infectious stomach contents entering the lungs.

Geriatric dentistry

Geriatric dentistry is the delivery of dental care to older adults involving diagnosis, prevention, management and treatment of problems associated with age related diseases. The mouth is referred to as a mirror of overall health, reinforcing that oral health is an integral part of general health. In the elderly population poor oral health has been considered a risk factor for general health problems. Older adults are more susceptible to oral conditions or diseases due to an increase in chronic conditions and physical/mental disabilities. Thus, the elderly form a distinct group in terms of provision of care.

Residential care refers to long-term care given to adults or children who stay in a residential setting rather than in their own home or family home.

Caregiver Person helping another with activities of daily living

A caregiver is a paid or unpaid member of a person's social network who helps them with activities of daily living. Since they have no specific professional training, they are often described as informal caregivers. Caregivers most commonly assist with impairments related to old age, disability, a disease, or a mental disorder.

Dislocation of jaw Medical condition

Dislocations occur when two bones that originally met at the joint detach. Dislocations should not be confused with Subluxation. Subluxation is when the joint is still partially attached to the bone.

Assistive eating devices

Assistive eating devices include devices ranging from low-tech utensils to high-tech powered robotic eating equipment. Low tech eating devices include utensils, plates and bowls with lips that make scooping food easier. Cups and mugs, and even a standard disposable straw can be considered assistive drinking devices. They are used by people when they have difficulty eating or drinking independently. These devices are typically used for people with disabilities, but can also be used for children or people that have poor dexterity. They can promote independence during meal times, but in many cases also can reduce the caregiver workload during meals. "Assistive eating devices can increase self-care, increase self-esteem associated with increased independence, increase safety during meals, and make meal-time better for caregiver staff…".

References

  1. 1 2 Gillick, M. R. (2000). "Rethinking the Role of Tube Feeding in Patients with Advanced Dementia". New England Journal of Medicine. 342 (3): 206–210. doi:10.1056/NEJM200001203420312. PMID   10639550.
  2. AMDA – The Society for Post-Acute and Long-Term Care Medicine (February 2014), "Ten Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation , AMDA – The Society for Post-Acute and Long-Term Care Medicine, retrieved 20 April 2015.
  3. Mitchell, S. L.; Buchanan, J. L.; Littlehale, S.; Hamel, M. B. (2004). "Tube-Feeding Versus Hand-Feeding Nursing Home Residents with Advanced Dementia: A Cost Comparison". Journal of the American Medical Directors Association. 5 (2): S23. doi:10.1016/S1525-8610(04)70086-9. PMID   14984607.

Further reading