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Advanced dementia swallowing — DGM MCQ

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HardDementiaAdvanced dementia swallowingDGM

A 91-year-old man with advanced dementia has recurrent aspiration and is eating very little. He is bedbound and no longer recognises family. His family ask about feeding options. Current medicines include no regular oral medicines. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Discuss goals of care and careful hand feeding where appropriate

In advanced dementia, feeding decisions should be individualised around comfort, risks and goals, with careful hand feeding often appropriate. Routine tube feeding does not reliably improve outcomes in advanced dementia, appetite stimulants do not address goals, bariatric review is irrelevant, and mouth care remains essential. Nutrition decisions should be framed as care planning, not abandonment.

Reference: NICE NG97; NICE NG31