Particular features in feeding and nutritional problems in geriatric patients with brain damage

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Yannis Dionyssiotis, MD,

Abstract from 13th Panhellenic Conference on Nutrition-Dietetics & 2nd Congress of Clinical Nutrition

The difficulty in chewing and swallowing can occur as a result of many different diseases and conditions which occur in long-term care of the elderly. Particular attention should be paid to metabolic differences in the nutritional status of patients in order to optimize the medical and neurological effects.
In the existence of brain injury, for example, in patients with advanced dementia or stroke, possible hypermetabolic and hypercatabolic responses may lead to harmful effects of malnutrition, to loss of lean body mass, to increased susceptibility to infections, and reduced healing wounds.
The nutritional needs include the need for energy, the need for protein, and the need for hydration. The assessment of the nutritional requirements includes more than a few simple calculations. Expertise from the care team in order to assess the clinical and morphometric data before applying the equations which provide energy and protein requirements is required.
Per os feeding is recommended in patients already weaned from tracheal tubes, awoken from coma, who execute commands and have good swallowing and bowel function. When feeding is difficult and dangerous for elderly taking food and fluids by mouth because of these and other constraints, the care team should consider the possibility of enteral feeding. It is important for healthcare professionals to understand the recent documented recommendations about the risks and benefits associated with the use of a feeding tube in this population.

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Yannis Dionyssiotis, MD, PhD, Abstract from 13th Panhellenic Conference on Nutrition-Dietetics & 2nd Congress of Clinical Nutrition
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