complications with dementia

Complications of Dementia

Dementia is a progressive disease that has the potential to cause many problems as it advances. Dysphagia is typically a later disease concern. Aspiration is a major problem in those who develop dysphagia. A speech therapist can perform a swallowing study and make recommendations to decrease the risk of aspiration. Some possible interventions include:

Altering the consistency of the food

Cutting food into smaller pieces

Changing the position of the patient when he or she swallows

Encouraging the patient to tuck the chin while swallowing

Eating with someone who can monitor for any aspiration or provide cues to safe eating

Some patients with dementia will hold food in their mouth, not swallow it and spit it out. This is common with frontotemporal dementia and is best treated with behavioral interventions.

The use of feeding tubes has fallen out of favor over the last number of years as they have not proven to extend life expectancy or improve quality of life. They can be utilized if aspiration is severe or patient does not eat enough to maintain nutrition and it is wanted by patient and durable power of attorney of health care. Feeding tubes do not prevent malnutrition, reduce incidence of aspiration pneumonia, improve function, or extend life (Li, 2002). If permanent feeding tube replacement is desired than percutaneous gastrostomy is better than a nasogastric tube. Consideration must be given to quality of life and complications when deciding on the use of a feeding tube. Hand feeding is an alternative to feeding tubes and it may provide more comfort to the patient.

Dementia is typically a later life disease when patients are prone to other illness. Those with dementia are typically older; older age comes with a greater risk of many chronic diseases. Having dementia makes it more likely that proper treatment will not ensue. For example, those with a heart attack may not be able to communicate the pain that they are feeling due to the dementia which will result in delayed care and worse outcomes.

Poor nutrition is another common complication of dementia. Poor nutrition increases the risk of infection and poor body healing. The combination of older age, poor communication and a compromised immune system make the demented individual at high risk for poor outcomes