Hansjee, Dharinee, Yoshimatsu, Yuki, Smithard, David, Markowski, Marianne ORCID: https://orcid.org/0000-0003-4652-3168 and Essex, Ryan ORCID: https://orcid.org/0000-0003-3497-3137 (2024) Decisions with eating and drinking in older adults admitted with pneumonia and referred for swallowing difficulties. European Geriatric Medicine. ISSN 1878-7649 (Print), 1878-7657 (Online) (doi:10.1007/s41999-024-00983-2)

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Abstract

Purpose
Older patients with pneumonia are commonly restricted from oral intake due to concerns towards aspiration. Eating and drinking with acknowledged risks (EDAR) is a shared decision-making process emphasising patient comfort. As part of our project to find the barriers and facilitators of EDAR, we aimed for this initial study to see how frequently EDAR was selected in practice.
Methods
We performed a retrospective cohort study at an acute hospital where EDAR was initially developed, of patients aged ≥ 75 years-old admitted with pneumonia and referred to speech and language therapy.
Results
Out of 216 patients, EDAR decisions were made in 14.4%. The EDAR group had a higher 1-year mortality than the modified/normal diet groups (p < 0.001). Pneumonia recurrence rate did not differ significantly between the groups (p = 0.070).
Conclusion
EDAR decisions were comparatively less common and most were associated with end-of-life care. Underlying reasons for the low EDAR application rate must be investigated to maximise patient autonomy and comfort as intended by EDAR while minimising staff burden.

Item Type:	Article
Uncontrolled Keywords:	dysphagia; aspiration pneumonia; choking; risk feeding; comfort feeding; modifed diet
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Related URLs:	Publisher
Last Modified:	13 May 2024 10:17
URI:	http://gala.gre.ac.uk/id/eprint/47164

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