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October 2016

Response to a Patient’s Failed Swallowing StudyDecisions Regarding Feeding Tubes and Dysphagia

Author Affiliations
  • 1Division of Palliative Medicine, Hartford Hospital, Hartford, Connecticut
  • 2Department of Medicine, University of Connecticut School of Medicine, Farmington
JAMA Intern Med. 2016;176(10):1431-1432. doi:10.1001/jamainternmed.2016.4759

Although I visited Mrs P every day for 1 week, she could never remember my name. She did recognize the young resident rounding with me each day though—we thought perhaps it was because of his beard.

She was a frail elderly woman with moderate debility and mild Parkinson disease. Prior to her hospitalization, she could ambulate in her apartment with a walker, ate a modified, soft diet, and needed assistance to carry out most of her activities of daily living. She had fallen at her assisted living facility, resulting in a hip fracture at the site of her prior hip surgery from a few years ago. She was seen by the orthopedics team in the emergency department, who recommended surgical repair of the hip once again. Prior to the surgery, she was seen by a hospitalist and cardiologist, and she underwent the repair the next day.

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