ACHA Publication: BMJ Editorial-Supporting eating and drinking in older people with dementia

Eating and drinking are about more than nutrition—they bring comfort, pleasure, and connection. In people with dementia, especially in later stages, eating can become difficult. For many years, feeding tubes (like PEG or nasogastric tubes) were used to provide nutrition when someone couldn’t eat by mouth. However, growing evidence shows that these tubes don’t help people with advanced dementia live longer or feel better, and they can cause harm, like infections or choking. In the UK, these interventions are now, appropriately, being used less frequently and there has been a shift in clinical practice.

Experts and national guidelines now recommend focusing on hand-feeding with foods the person enjoys, even if there’s a risk they might cough or choke. This approach, known as “comfort feeding” or “feeding at risk,” aims to maintain quality of life.

Decisions about feeding often happen during hospital stays and can be emotionally complex. It’s important to rule out treatable issues like infections or pain before deciding on long-term feeding solutions. Conversations with families and healthcare teams—supported by tools and guidance—can help align care with a person’s values and wishes.

Feeding decisions in dementia need to be personalised, compassionate, and based on what is best for the individual. More research and better understanding of how to best involve people with dementia and their families in these difficult decisions are needed to improve care across all settings. You can read the article in full here