Authors (including presenting author) :
Sau Lai LEE, PMH WM(LKB) Kai Man AU Dr, PMH CON(Med&Geri) Kitty YEUNG, PMH DOM(LKB) Man Fong YIU, PMH WM(LKB) Shirley LEUNG, PMH WM(LKB)
Affiliation :
Lai King Building, Princess Margaret Hospital
Introduction :
Lai King Building (LKB) provides rehabilitation, convalescent and infirmary care. Some patients in LKB with / without advanced dementia who have feeding problems. It will cause tremendous stress and frustration to relatives or carers. Nasogastric tube insertion for artificial feeding is a common practice for those in hospital and result in various complications. However, evidence suggests careful hand feeding can be a feasible alternative to be offered to the patients. This program aims to provide a safe and quality choice for patients to enhance their quality of life and support to those relatives / carers, LKB started Dementia / Dependent Eating Enhancement Program (DEEP) since 2018.
Objectives :
1. To provide alternative safe with quality feeding method to elderly patients with feeding problem. 2. To increase staff knowledge and awareness of the poor feeding problems of advanced dementia / frail older adults. 3. To equip nurses and health care assistants on “Careful Hand Feeding” skills. 4. To provide education to relatives/ carers on comfort feeding strategies and “Careful Hand Feeding” (CHF) skills. 5. To enhance patient’s quality of life and support to their family members/ carers.
Methodology :
1. Enhance patient care service through inter-disciplinary team approach: - Medical - Nursing - Speech therapy - Dietetic - Family and carer 2. Develop Dementia / Dependent Eating Enhancement Program (DEEP) guideline and the contents including: - Flowchart on management of poor feeding problems in advanced dementia / dependent or frail older adults - Careful Hand Feeding Cue Card - Pamphlet of “關愛人手餵飼單張” - 病人進餐份量”記錄指引 - Careful Hand Feeding Consent - DEEP Care Plan 3. Conduct staff training: - Train-the-Trainer (TTT) program on Careful Hand Feeding technique - In-service training yearly
Result & Outcome :
In conclusion, the DEEP is welcomed to patient with feeding problems. It provides a safe and quality choice for patients and carers. Moreover, it increases staff awareness of the poor feeding problems of advanced dementia / frail elderly patient. Through the TTT training and in-service training, it also increases staff knowledge and confidence on care of patient with CHF. Besides, this enhancement program through team approach to increase patient quality of life and decrease relatives’ / carers’ stress.
