| Knowledge |
Action |
If a patient is not eating, it is important to address this from day # 1 of their hospitalization (see "Patient won't eat" - Quick Consult).
Eating problems are usually aggravated by intercurrent illness and thus, often present problems when the patient is hospitalized.
Look for reversible causes.
These include infection (UTI), medication side effects, constipation, ulcers, gastritis, etc.
|
- Address eating difficulties.
- Find reversible causes.
|
The patient should sit up in a chair to eat if possible, offered appetizing food and carefully fed if they are incapable of feeding themselves.
Medications that cause anorexia should be avoided, bowel function should be optimized, pain controlled and sedation avoided.
If patients still refuse to eat, address the question of PEG placement sooner rather than later.
Nasogastric (NG) feeding is generally not a good solution as it will seldomly be possible to discharge your patient with an NG tube.
Nursing homes do not accept NG tubes any longer because of the risk of displacement and aspiration.
If recovery does not occur, experience is often helpful in deciding when to shift from NG to PEG feeding.
If in doubt, ask for help from someone with experience.
The Geriatric Consult Service is available to help you with these matters.
|
- Make patient comfortable during feeding.
- Address PEG placement early on.
- Ask for help.
|
|
