Comfort feeding OK for those with advanced dementia, regardless of advance directives: AMDA

When deciding whether to offer food and fluids to a resident with advanced dementia, clinicians have a greater responsibility to the resident in their current state than to those who originally drew up an advance directive that calls for food and drink to be withheld, according to the authors of a new white paper.

Contrary to some clinicians’ views on the subject, stopping eating and drinking by advance directive is not identical to voluntary stoppage by the resident themselves, argue members of The Society for Post-Acute and Long-Term Care Medicine, or AMDA. Instead, AMDA’s ethics subcommittee views the two decisions as “significantly different,” they wrote. 

With that in mind, AMDA recommends adopting a policy of comfort feeding for all nursing and assisted living facility residents with advanced dementia, “despite any advance directives to the contrary,” the authors wrote in the current paper. Comfort feeding involves providing food and fluids while residents continue to accept it.