[Dysphagia] FWD: urgent query!

[Paula.Leslie at newcastle.ac.uk (Paula leslie)]

Hello All

Just got this from a colleague of mine.  I'm not an ALD expert.  Can anyone 
help?

Thanks

Paula



hi - can anyone help with the query below - will collate and send on!
many thanks -


....
We are having a difficult, diplomatic issue with a local consultant who
is adamant that a lady with Downs dementia and dysphagia should not be
PEG fed as the consultant believes that this would merely prolong her
life unnecessarily.  The consultant's belief is that our experience is
not replicated in the community where the consultant claims clients die
soon after the onset of dysphagia, although we suspect this  is because
such patients dies from lack of nutrition, not from the dementia.  This
has been an issue with other consultants in the past, but this
particular discussion is causing us some difficulty.



The local consultant is asking for evidence to support our experience
that

1) Dysphagia occurs in the middle/late third of the condition, not as a
new symptom in the terminal stages (ie hours or days) as in other forms
of dementia.

2) PEG feeding improves the quality of life of these patients by
reducing chest infections and preventing symptoms of malnourishment

3) Not inserting a PEG results in a prolonged illness of repeated chest
infections and malnutrition symptoms which, if the patient can manage
some feeding, may go on for more than 6 months (18 months in one of our
ladies).

Paula Leslie
Degree Programme Director
Surgical and Reproductive Sciences
Faculty of Medical Sciences
University of Newcastle
Newcastle upon Tyne
NE2 4HH
UK
+44 (0) 191 222 6279(T)/8988(F)
http://www.ncl.ac.uk/sars/postgrad/MSc.htm