Feeding decisions in advanced dementia: beliefs of caregivers and nursing technicians in a cross-sectional study

OBJECTIVE: To assess the beliefs and perceptions of caregivers regarding feeding management in patients with advanced dementia at one of the largest female long-term care institution in Rio Grande do Sul, Brazil. METHODS: An observational, cross-sectional, exploratory study was conducted using a self-administered questionnaire applied to caregivers and nursing technicians working at the institution. RESULTS: Among respondents, 78.7% believed that nasogastric tube feeding was the only therapeutic option for nutrition. Additionally, 70.2% considered oral comfort feeding to be an intervention that hastens death, and 85.1% believed that the absence of artificial nutrition would inevitably lead to death. Furthermore, 51.1% agreed that artificial feeding reduces the risk of aspiration, pressure injuries, and hospitalizations, as well as providing comfort and prolonging life, despite the lack of supporting evidence in the scientific literature. Notably, 66% of participants reported having received prior training on feeding management in advanced dementia. CONCLUSION: These findings highlight inconsistencies between the perceptions of caregivers and nursing technicians and evidence-based practices regarding feeding in advanced dementia. There is a clear need for targeted education and continuous training programs to promote informed decision-making and support evidence-informed care for this vulnerable population.