Feeding a Person with Advanced Alzheimer's Disease: An Update

Abstract

We update our 2011 discussion of feeding the person with late-stage or advanced Alzheimer's disease (advanced AD). We present a case of a 92-year-old woman diagnosed with AD, from our family medicine practice who was brought to the emergency department with fever and a change in mental status. Previously, neither she nor her family had received counseling about the typical trajectory of AD, nor had she made end-of-life plans. We present a discussion of the typical trajectory of AD, involuntary weight loss, advance care planning related to nutrition, and hydration and alternatives to tube feeding. We added a note describing the initial impact of COVID-19 on care.