Case history 1

1
Case history 1

• A 55 yr old woman with one year history of fairly
  rapidly progressive MND.
• Speech and swallowing deteriorating. Speech
  therapist recommends PEG feeding for safety.
• Husband keen for wife to have PEG. Wife wants to
  wait longer till really needs it and to keep
  trying to eat.
• Neurologist thinks likely to get aspiration
  pneumonia if waits much longer
• What do you do?

2
Case history 2

• A 75 year old lady with dementia is in a nursing
  home. She appears to fairly content but cannot
  recognise family or friends and no longer takes
  part in any activity. She does not have coherent
  conversations.
• She has been gradually eating and drinking less
  and less, and finally stops taking anything at
  all (on a Friday). Her family want her to have a
  PEG urgently to make her feel better.
• What do you do?