{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T06:51:46Z","timestamp":1770360706571,"version":"3.49.0"},"reference-count":0,"publisher":"Sociedade Portuguesa de Medicina Interna","issue":"1","license":[{"start":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T00:00:00Z","timestamp":1638921600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["RPMI"],"abstract":"<jats:p>A dem\u00eancia \u00e9 uma s\u00edndrome neurol\u00f3gica de agravamento progressivo, sem cura, cuja preval\u00eancia tem vindo a aumentar devido ao envelhecimento da popula\u00e7\u00e3o. Existe um grande desconhecimento entre profissionais de sa\u00fade e cuidadores relativamente \u00e0 melhor abordagem da alimenta\u00e7\u00e3o nos doentes com dem\u00eancia avan\u00e7ada. Dado n\u00e3o existirem recomenda\u00e7\u00f5es nacionais acerca deste tema, foi elaborado um documento de consenso da Sociedade Portuguesa de Medicina Interna e da Associa\u00e7\u00e3o Portuguesa de Nutri\u00e7\u00e3o Ent\u00e9rica e Parent\u00e9rica que explicita as orienta\u00e7\u00f5es existentes relativas \u00e0 abordagem dos problemas alimentares nos doentes com dem\u00eancia avan\u00e7ada.\r\nA dem\u00eancia avan\u00e7ada \u00e9 uma condi\u00e7\u00e3o terminal em que deve ser privilegiado o conforto do doente, frequentemente acamado, incapaz de comunicar verbalmente e com dificuldade na alimenta\u00e7\u00e3o. Nesta popula\u00e7\u00e3o, a literatura atual n\u00e3o recomenda o uso de alimenta\u00e7\u00e3o por sonda (nasog\u00e1strica, nasojejunal, gastrostomia percut\u00e2nea ou jejunostomia percut\u00e2nea), que est\u00e1 associada a maior risco de infe\u00e7\u00e3o, maior utiliza\u00e7\u00e3o de meios de conten\u00e7\u00e3o e de- senvolvimento de \u00falceras de dec\u00fabito. Como alternativa, recomenda-se a alimenta\u00e7\u00e3o por via oral de acordo com a toler\u00e2ncia e vontade do doente (alimenta\u00e7\u00e3o de conforto). Do ponto de vista \u00e9tico e legal, \u00e9 leg\u00edtimo n\u00e3o proceder \u00e0 artificializa\u00e7\u00e3o da alimenta\u00e7\u00e3o na fase terminal da dem\u00eancia caso este procedimento seja contr\u00e1rio aos valores da pessoa e n\u00e3o se objetivem benef\u00edcios. Esta decis\u00e3o deve ser tomada ap\u00f3s discuss\u00e3o multidisciplinar incluindo o doente (se poss\u00edvel), representante legal, cuidadores, fam\u00edlia e equipa de profissionais de sa\u00fade envolvidos, elaborando um plano individual de cuidados que permita a tomada de decis\u00f5es no melhor interesse do doente.<\/jats:p>","DOI":"10.24950\/guidelines\/consensus\/1\/2020","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T10:23:49Z","timestamp":1639045429000},"page":"80-88","source":"Crossref","is-referenced-by-count":2,"title":["Alimenta\u00e7\u00e3o na Dem\u00eancia Avan\u00e7ada: Documento de Consenso da Sociedade Portuguesa de Medicina Interna e da Associa\u00e7\u00e3o Portuguesa de Nutri\u00e7\u00e3o Ent\u00e9rica e Parent\u00e9rica"],"prefix":"10.24950","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6881-1657","authenticated-orcid":false,"given":"Ana","family":"Pessoa","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4879-559X","authenticated-orcid":false,"given":"Paulo","family":"Almeida","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7091-3911","authenticated-orcid":false,"given":"Ricardo","family":"Marinho","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9273-5650","authenticated-orcid":false,"given":"Sofia","family":"Duque","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3998-6730","authenticated-orcid":false,"given":"Teresa","family":"F. 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