Nutrition of people with advanced dementia

Uvod: Napredovala stopnja demence je terminalna stopnja v kliničnem poteku demence, za katero sta poleg kognitivnih, telesnih, vedenjskih in psiholoških okvar značilna izguba samostojnosti pri izvajanju osnovnih dnevnih opravil ter visoko tveganje za podhranjenost. Namen raziskave je predstaviti pristope za zagotavljanje optimalne prehranjenosti pri osebah z napredovalo stopnjo demence v institucionalni oskrbi. Metode: Narejen je bil integrativni pregled literature, objavljene med letoma 2014 in 2019. Za identifikacijo relevantne literature smo uporabili iskalni niz dementia OR alzheimers OR cognitive impairment OR memory loss AND feeding OR eating OR nutrition, pregledani sta bili podatkovni bazi CINAHL in MEDLINE. V končno analizo je bilo vključenih 19 člankov. Rezultati: Izsledki pregleda literature so bili razporejeni v štiri kategorije: (1) spodbujanje samostojnosti pri hranjenju, (2) uporaba prilagojene prehrane, (3) obvladovanje motenj požiranja in (4) na posameznika usmerjena oskrba. Diskusija in zaključek: Pristopi pri zagotavljanju kakovosti življenja oseb z napredovalo stopnjo demence so usmerjeni k spodbujanju samostojnosti pri hranjenju. Slednje se lahko dosega z intervencijami na področju obvladovanja upada umskih in telesnih sposobnosti, motenj požiranja, z zagotavljanjem prehranskega vnosa per os ter izvajanjem oskrbe, usmerjene k posamezniku.Introduction: Advanced dementia is a terminal stage in the clinical course of dementia, characterized by the loss of autonomy in conducting basic activities of daily living and a high risk of malnutrition in addition to severe cognitive, physical, behavioural, and psychological impairment. The article presents approaches to achieving optimal nutrition in the elderly with advanced dementia in long-term care. Methods: An integrative review of the literature published between 2014 and 2019 was conducted. Using the keywords (dementia OR alzheimers OR cognitive impairment OR memory loss) AND (feeding OR eating OR nutrition) databases MEDLINE and CINAHL with full texts were searched. The final review included 19 studies. Results: Based on literature review, the four thematic areas were identified: (1) promoting self-feeding, (2) use of tailored nutrition, (3) swallowing disorder management, (4) person-centred care. Discussion and conclusion: Approaches to improve or maintain the quality of life of people with advanced dementia focus on encouraging self-feeding and eating independence, which may be achieved through management of mental, functional and swallowing problems, promotion of oral food intake and provision of person-centred care