Social Determinants of Maintaining Nutrition in Older Adults with Advanced Dementia

Dysphagia is recognised as part of the frailty syndrome, especially for those at the end of life. There is a tension in management between the need to optimize nutrition status as part of the management of oral frailty, and respecting the wishes of patients and/or family members in the form of advance care planning and advance directives regarding to artificial nutrition and hydration. Management will likely be influenced by many social determinants, rather than solely be based on evidence from clinical research.