Thickened fluids for people with dementia in residential aged care facilities

Aim This systematic review aimed to establish best practice in relation to thickened fluids for people with dementia living in residential aged care facilities. Methods This review considered all types of studies that examined the prescription and administration of thickened fluids to people with dementia in residential aged care facilities. English-language articles published from 1995 to 2008 were sought in a comprehensive search of an extensive range of databases, online sources and unpublished literature. Two independent reviewers critically appraised each article using the relevant Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI-SUMARI) instruments, then data were extracted from those articles that met the inclusion criteria. No meta-analysis was possible because of significant clinical and methodological heterogeneity, therefore results are reported narratively. Results From 112 papers originally identified, 14 met the inclusion criteria and formed the basis of the findings. Nine studies recommend the use of thickened fluids as a strategy to maintain adequate fluid intake for persons with dementia with dysphagia in residential aged care and four papers recommend their use for people with dementia in general. One paper reported that the use of thickened fluids was found to be acceptable to older people in the event of dementia and dysphagia. Conclusions From the retrieved data, evidence-based best practices cannot be concluded. It can, however, be cautiously inferred that thickened fluids may be effective for residents with dementia if set guidelines are instituted.