Outcomes of Feeding Problems in Advanced Dementia in a Nursing Home Population

<jats:sec> <jats:title>Objectives</jats:title> <jats:p>To describe quality of care for feeding problems in advanced dementia and probability and predictors of weight loss and mortality.</jats:p> </jats:sec> <jats:sec> <jats:title>Design</jats:title> <jats:p>Prospective cohort.</jats:p> </jats:sec> <jats:sec> <jats:title>Setting</jats:title> <jats:p> Twenty‐four nursing homes ( <jats:styled-content style="fixed-case">NH</jats:styled-content> s). </jats:p> </jats:sec> <jats:sec> <jats:title>Participants</jats:title> <jats:p>Nursing home residents with advanced dementia and feeding problems and family surrogates (N = 256).</jats:p> </jats:sec> <jats:sec> <jats:title>Measurements</jats:title> <jats:p>Family reported on quality of feeding care at enrollment and 3 months. Chart reviews at enrollment and 3, 6, and 9 months provided data on feeding problems, treatments, weight loss of more than 5% in 30 days or more than 10% in 6 months, and mortality. Organizational variables were obtained from administrator surveys and publically reported data.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Residents with advanced dementia and feeding problems had an average age of 85; 80% had chewing and swallowing problems, 11% weight loss, and 48% poor intake. Family reported feeding assistance of moderate quality; 23% felt the resident received less assistance than needed. Mortality risk was significant; 8% died within 3 months, 17% within 6 months, and 27% within 9 months. Residents with advanced dementia who had stable weight over 3 months had a 5.4% rate of significant weight loss and a 2.1% risk of death over the next 3 months. Residents with advanced dementia and weight loss over 3 months had a 38.9% chance of stabilizing weight over the next 3 months but also had a 19.2% chance of dying. Weight loss was the only independent predictor of death.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Weight loss is a predictor of death in advanced dementia. Treatments can often stabilize weight, but weight loss should be used to trigger discussion of goals of care and treatment options.</jats:p> </jats:sec>