What would you do ? Elderly 86 yr. old man Lives on his own Widow No Hx from GP re weight changes Acute Haemorrhagic Weight o/a 58kg BMI 19 Grade 3 Pressure Ulcer Low K, Mg, PO4

Phase 2 Naso - gastric tube placement sucessful Advised to hydrate and feed to protein and energy requirements What monitoring or evaluation needs to occur ?

Phase 3 Seen by S.A.L.T. Assessment shows can start puree and custard What do you do with the N.G and what do you monitor?

Phase 4 On thickened fluids, managing 500mls Food record charts show eating ½ puree meals and custards What is your nutrition plan ?

Phase 5 N.G ‘fell’ out! Can’t replace Not meeting nutrition / hydration requirements Pressure ulcer has healed 2kg weight loss S.A.L.T r/v predicts that swallow function unlikely to improve What are the options to meet requirement ?s

Phase 6 Discussions for Gastrostomy ( P.E.G. ) What things do we need to assess / consider for this ?