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Center for Research on Learning and Teaching at University of Michigan

When Eating Problems Arise in Advanced Dementia: An Interdisciplinary Trigger Video

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This is an interactive seminar centered on a trigger video depicting a family meeting with the treating physician, the speech and language pathologist and the family of a patient with advanced dementia who suffers from dysphagia/poor oral intake. The seminar can be provided to a small group of 4-10 healthcare trainees (medical residents or students, nursing students, speech and language pathology students, social work students). The seminar is designed to present the learners with an interdisciplinary approach to conducting a family meeting on this topic. It starts with reading a case presentation, which is meant to emphasize the need for a family meeting, followed by playing the video until a trigger question comes up. At that point the participants are asked to reflect on the question and share their answers with the group. The group then watches the video exemplifying a way the question can be discussed. The process is repeated for all the trigger questions. At the end of the seminar the trainees are encouraged to debrief on language that could be modeled for goals of care discussions as well as aspects of the discussion that could have been approached differently. They are also provided with all the references used in the video as a resource for future family meetings. Trainees are asked to complete a short retrospective pre/post self-assessment survey. 

Educational objectives: 
  1. Review importance of completing advance directives (applied to patients with dementia); define surrogate decision maker, substituted judgment, and best interest concepts and discuss advance care planning for the case presented.
  2. Describe the natural history of advanced dementia.
  3. Become familiar with potential treatment burdens associated with tube feeding in patients with advanced dementia.
  4. Appreciate various options for eating/feeding in advanced dementia and swallowing problems.
  5. Analyze aspects of difficult conversations with surrogate decision makers.


Publications from, presentations from, and/or citations to this product: 

Some of the materials for this seminar were presented during the Marketplace at the Reynolds Meeting in Las Vegas, Oct 7, 2014.


 "When Eating Problems Arise in Patients with Advanced Dementia- An Interdisciplinary Approach to

Communicating with Caregivers" This interactive seminar was presentated at the Annual

Assembly of the American Association of Hospice and Palliative Medicine Annual Meeting, February 2015, Philadelphia.



Date posted: 
Fri, 06/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 06/17/2016
Contact Person/Corresponding Author:

Suggested Citation:
When Eating Problems Arise in Advanced Dementia: An Interdisciplinary Trigger Video. POGOe - Portal of Geriatrics Online Education; 2016 Available from:
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