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Dysphagia and aspiration risk in Parkinson's disease — SCE Acute Medicine MCQ

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ModerateMedicine in the elderlyDysphagia and aspiration risk in Parkinson's diseaseSCE Acute Medicine

A 78-year-old woman with Parkinson's disease is admitted from a nursing home with aspiration pneumonia. She coughs when drinking water and has had three chest infections in six months. She is alert and wants to keep eating, but her daughter asks for a nasogastric tube to prevent aspiration. What would you advise this patient and family?

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Correct answer: E — Explain that tube feeding does not reliably prevent aspiration and discuss risk-feeding decisions with speech and language therapy

Aspiration risk in neurodegenerative disease is best managed through capacity-sensitive shared decision-making, swallowing assessment and realistic discussion of benefits and burdens. Tube feeding may not prevent aspiration because reflux and saliva aspiration can continue. Indefinite nil by mouth or parenteral nutrition is rarely proportionate without a clear reversible plan.

Reference: RCP Oral Feeding Difficulties Guidance; NICE NG97