title: Social Ecological Perspectives of Tube-Feeding Older Adults with Advanced Dementia: A Systematic Literature Review.
abstract: Dementia is a progressive, debilitating disease that often results in weight loss, malnutrition, and dehydration. Feeding tubes are often prescribed; however, this practice can lead to complications. The purpose of this systematic review was to examine the use of feeding tubes in elderly demented patients from a social ecological perspective. Results indicated that family members often receive inadequate decision-making education. Many health care professionals lack knowledge of evidence-based guidelines pertaining to feeding tube use. Organizational and financial reimbursement structures influence feeding tube use. Feeding practices for patients with advanced dementia is a complex issue, warranting approaches that target each level of the Social Ecological Model.
authors.affiliation: a Department of Human Nutrition and Hospitality Management , The University of Alabama , Tuscaloosa , Alabama , USA.
authors.forename: Joy W
authors.initials: JW
authors.lastname: Douglas
authors.affiliation: a Department of Human Nutrition and Hospitality Management , The University of Alabama , Tuscaloosa , Alabama , USA.
authors.forename: Jeannine C
authors.initials: JC
authors.lastname: Lawrence
authors.affiliation: b College of Human Environmental Sciences , The University of Alabama , Tuscaloosa , Alabama , USA.
authors.forename: Lori W
authors.initials: LW
authors.lastname: Turner
mesh_terms: D000368:Aged; D017028:Caregivers; D003657:Decision Making; D003704:Dementia / Q000451:nursing*; D004750:Enteral Nutrition / Q000009:adverse effects / Q000191:economics; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D011788:Quality of Life; D012931:Social Environment
keywords: Advanced dementia; social ecological model; tube feeding