Alimentação em pacientes

com demência avançada

O que precisamos saber?

Guia de orien†ações
Letícia Garcia Vasconcelos Coelho
Edison Iglesias de Oliveira Vidal
 Alimentação em pacientes
com demência avançada
O que precisamos saber?

!"#$%&'()'*%&'(+',%-.%"/-,(0-"/1-

23&,-.(45/",&',(3"(6/&7"&*'(+&3'/

i
 8/&9".#':;-("9(<'%&".#",(%-9(3"9=.%&'(('7'.:'3'

6(>?"(<*"%&,'9-,(,'@"*A

8?#-*",

!"#$%&'()'*%&'(+',%-.%"/-,(0-"/1-
23&,-.(45/",&',(3"(6/&7"&*'(+&3'/

B"7&,-*",

A*-VG(J*'G(<"*.'.3'(9-.-(<:W:,1&K'
A*-VG(J*'G(J'.&"/'(@'/'#"(9&'5&-.&(+:/%'.-(
A*-VG(J*'G(<*'.%"/&,"(A&7"##'(X-Y:"
A*-VG(J*'G(@&/7&'(Z:,#&.'(A'F&.&
A*-V'G(J*'G(='*&'(["/".'(9-*5'#-
A*-V'G(J*'G(0',,&'.'(=".3",(9"*#-.%"//-(<-.#",(

23&#-*':;-("(3&'5*'9':;-C

J*'G(S.'(@&/7&'(@G(9G(@G(<"**"&*'(\(0--*3".'3-*'(?2SJG]4@(^(<=9(

0*&':;-(3"(<"*,-.'5"9(

0/'*'(<:K",(S**:3'(

8/&9".#':;-("9(<'%&".#",(%-9(3"9=.%&'(('7'.:'3'
6(>?"(<*"%&,'9-,(,'@"*A

!"#$%&'()'*%&'(+',%-.%"/-,(0-"/1-("(23&,-.(45/",&',(3"(6/&7"&*'(+&3'/(8(9-#:%'#:;(<'%:/3'3"(3"(="3&%&.'(
3"(9-#:%'#:8>?2@A(BCBD

BEFG

4@9?;͛͜͝Ǧ͚͙Ǧ͚͗͗͘͜Ǧ͖͛Ǧ͖
DGJ"KL.%&'(BG(?:#*&MN-(".#"*'/(EG()',#*-,#-K&'(O(='.:'&,P(5:&',P("#%(QG(0:&3'3-,(F'/&'#&7-,(RG(?:#*&MN-
8S,F"%#-,(3'(@'T3"(UG(@'T3"(8(S,F"%#-,(?:#*&%&-.'&,

ii
Apresentação
2,#"( 5:&'( #"K( %-K-( -_`"#&7-( '`:3'*( '( ",%/'*"%"*( V'K&/&'*",( "( %:&3'3-*",( 3"(
F'%&".#",(%-K(3"KL.%&'("K(V',"('7'.M'3'(Y:'.#-(a,(-FMb",(3"('/&K".#'MN-(
"I&,#".#",( F'*'( ",,",( F'%&".#",P( 3"( V-*K'( '( %-.#*&_:&*( F'*'( ,":( %-.V-*#-( "(
Y:'/&3'3"(3"(7&3'G

3
Vamos conversar?
Neste guia você irá receber informações sobre:

((6(Y:"(c(3"KL.%&'

((d:'&,(-,(,&.'&,("(,&.#-K',(3'(3"KL.%&'('7'.M'3'

(S,(F*&.%&F'&,(%-.,"Y:L.%&',(3'(3"KL.%&'("K(V',"('7'.M'3'(*"/'%&-.'3',(
a('/&K".#'MN-(e%-K"*P(_"_"*("(".5-/&*f

(J"%&,b",('(,"*"K(#-K'3',("K(%-.`:.#-(%-K('("Y:&F"(K:/#&F*-H,,&-.'/(3"(
,'T3"(,-_*"('('/&K".#'MN-(3"(F'%&".#",(%-K(3"KL.%&'("K(V',"('7'.M'3'

( 0-K-( -V"*"%"*( '/&K".#'MN-( 3"( %-.V-*#-( F'*'( F'%&".#",( %-K( 3"KL.%&'(

"K(V',"('7'.M'3'
O QUE É
DEMÊNCIA?
 O QUE É DEMÊNCIA?
! •! S,(3"KL.%&',(,N-(:K(5*:F-(3"(3-".M',(3-(%c*"_*-(Y:"(F-3"K(/"7'*('(F",,-'('(
#"*(3&H%:/3'3",(3"(K"Kg*&'P(3'(%'F'%&3'3"(3"(F".,'*P(V'/'*P(3"(,"(*"/'%&-.'*(%-K(-:#*',(
F",,-',(-:(3"(%:&3'*(3"(,&(K",K'G

( h( J"( V-*K'( 5"*'/P( ',( 3"KL.%&',( ,N-( 3-".M',( F*-5*",,&7',P( -:( ,"`'P( Y:"( 7N-(
F&-*'.3-( %-K( -( F',,'*( 3-( #"KF-P( "( Y:"( /"7'K( a( F&-*'( 3-( V:.%&-.'K".#-( K".#'/( "( 3"(
7i*&',(F'*#",(3-(%-*F-(Y:"(3"F".3"K(3-(%c*"_*-(F'*'(V:.%&-.'*(%-**"#'K".#"G

( h( 2I&,#"K(7i*&-,(#&F-,(3"(3"KL.%&',P(%-K-('(3-".M'(3"(S/j1"&K"*P(Y:"(c('(V-*K'(
K'&,(%-K:K(3"(3"KL.%&'P(',(3"KL.%&',(7',%:/'*",P(Y:"('%-.#"%"K(3"F-&,(3"(3"**'K",(
%"*"_*'&,(eS+0fP('/cK(3"(K:&#',(-:#*',(K".-,(%-K:.,G

( h( 4.3"F".3".#"K".#"(3'(%':,'P(Y:'.3-(:K'(3"KL.%&'(",#i("K(:K'(V',"(K:&#-(
'7'.M'3'('(F",,-'(F-3"('F*",".#'*(3&H%:/3'3",(F'*'(K',#&5'*("(".5-/&*(#'.#-('/&K".#-,(
Y:'.#-(/$Y:&3-,("('#c(K",K-(,:'(F*gF*&'(,'/&7'G
6
 Quais os sinais de que uma demência
está em fase avançada?

( h( )*'.3"( 3"F".3L.%&'( "K( *"/'MN-( a,( '#&7&3'3",( _i,&%',( 3"(

':#-%:&3'3-G( A-*( "I"KF/-P( .N-( %-.,"5:&*( K'&,( ,"( '/&K".#'*(
,-j&.1-("(.N-(%-.,"5:&*(K'&,(%-.#*-/'*(',(V"j",("('(:*&.'G

( h( )*'.3"( 3&V&%:/3'3"( F'*'( ,"( %-K:.&%'*P( V'/'.3-( K:&#-(

F-:%',(-:(Y:',"(.".1:K'(F'/'7*'(F-*(3&'G

( h( J&V&%:/3'3"("K(V&%'*(,".#'3-(,"K('F-&-G
 Em relação à nutrição, uma pessoa
com demência em fase avançada
pode:
( h( SF*",".#'*(3&H%:/3'3"("K(".5-/&*('/5:.,('/&K".#-,

( h( ?N-(,".#&*(V-K"("P(F-*(&,,-P(.N-(#"*(7-.#'3"(3"(%-K"*

O que essa dificuldade de se

alimentar pode causar?
( h( A"*3'(3"(F",-

( h( J",&3*'#'MN-

( h( S,F&*'MN-P(Y:"(c(Y:'.3-(-('/&K".#-(e,g/&3-(-:(/$Y:&3-f(-:(
'(,'/&7'(7'&(F'*'*(.-(F:/KN-P(F-3".3-(%':,'*(F.":K-.&',

8
 Quais são as opções de tratamento
relacionados à nutrição para pessoas com
demência em fase avançada?
d:'.3-( '( F",,-'( Y:"( #"K( 3"KL.%&'( "K( V',"( '7'.M'3'( ",#i( %-K(
F*-_/"K',(F'*'(%-K"*(-:(".5-/&*P(#"K-,(3:',(",%-/1',;(

( Df( S/&K".#i8/'( F"/'( _-%'( '#*'7c,( 3"( :K( F*-%",,-( %1'K'3-( 3"(
'/&9".#':;-(3"(%-.D-*#-

6E

( Bf( <-*."%"*( '( '/&K".#'MN-( F-*( :K'( ,-.3'P( Y:"( F-3"( ,"*( %-/-%'3'(
F"/-(.'*&j(-:(F"/'(_'**&5'G

2,,'(",%-/1'(3"7"(,"*(V"&#'(F"/-(*"F*",".#'.#"(3-(F'%&".#"(`:.#'K".#"(
%-K(-(Kc3&%-("(-:#*-,(F*-V&,,&-.'&,(3'(,'T3"(Y:"(",#N-(".7-/7&3-,(.-,(
%:&3'3-,(3"(,'T3"(3-(F'%&".#"G
 O que é alimentação de conforto?
k( '( '/&K".#'MN-( F-*( _-%'P( -V"*"%&3'( F-*( :K( %:&3'3-*P( -.3"( ,N-(
-V"*#'3-,( '/&K".#-,( 3'( F*"V"*L.%&'( 3-( F'%&".#"P( -:( ,"`'P( 'Y:"/",(
'/&K".#-,(3"(Y:"("/"(K'&,(5-,#'P(.'(%-.,&,#L.%&'("(Y:'.#&3'3"("K(
Y:"("/"('%"&#"(,"K(,&.'&,(3"(3",%-.V-*#-G(@N-("I"KF/-,(3"(,&.'&,(3"(
3",%-.V-*#-;(%'*"#',P(".5',5-,(V*"Y:".#",("(*"%:,'(3-(F'%&".#"("K(
*"%"_"*( -( '/&K".#-( e7&*'.3-( -( *-,#-( Y:'.3-( -( '/&K".#-( c(
-V"*"%&3-fG

F'( .?#*&:;-( 3"( %-.D-*#-( -( -@G"#&7-( .;-( H( -D"*"%"*( ?9'(

3"#"*9&.'3'( >?'.#&3'3"( 3"( %'/-*&',( -?( .?#*&".#",I( 9',(
-D"*"%"*(%-.D-*#-("(%'*&.1-('#*'7H,(3'('/&9".#':;-J
6,( '/&K".#-,( Y:"( ,N-( K"/1-*( '%"&#-,( %-,#:K'K( ,"*( -,( '/&K".#-,(
K'&,( '3-%&%'3-,P( V*",%-,P( "K( #"KF"*'#:*'( K-*.'( '( 5"/'3'P( "K(
%-.,&,#L.%&'(F',#-,'('(/$Y:&3'G(A-*("I"KF/-;(&-5:*#",P(,:%-,P((V*:#',P(
7&#'K&.',( 3"( V*:#',P( ( F'F',( 3"( V*:#'P( ,-*7"#",( "( 5"/'#&.',G( @"( -,(
F'%&".#",( ".5',5'K( %-K( /$Y:&3-,P( ",#",( F-3"K( ,"*( ",F",,'3-,(
:,'.3-(",F",,'.#",(%-K"*%&'&,(-:(%',"&*-,G(

A'*'(':K".#'*('(Y:'.#&3'3"(3"(%'/-*&',(-V"*#'3',P(F-3"8,"(%-/-%'*;(
K"/( "( '7"&'( .',( V*:#',P( ,:%-,( "( 7&#'K&.',l( 'j"&#"P( %*"K"( 3"( /"&#"P(
Y:"&`-(*'/'3-("(V'*&.1',(e(V'*&.1'(3"(K'.3&-%'P(3"(K&/1-P(3"(/&.1'M'P(
3"('7"&'f(.-(V"&`N-P(.',(,-F',G(S/cK(3&,,-(#'K_cK(c(F-,,$7"/(:.&*(-(
:,-(3"(,:F/"K".#-,(.:#*&%&-.'&,(%-K('('/&K".#'MN-G

10
 VANTAGENS e DESVANTAGENS DA
ALIMENTAÇÃO DE CONFORTO

VANTAGENS DESVANTAGENS

!"#"$%&'#"'#()"*#+,&#-"./")/"
#-('/*+#&0"1%./*.%"%$/&/2/&"
]-K'(:K(K'&-*(#"KF-(3-(%:&3'3-*(
#-('/*+%)"/"3/3(.#)"1&/$/&(.#)"./"
F'*'('/&K".#'*(-(F'%&".#"
#2%&.%"2%'"#"#2/(+#45%"./"2#.#"
1#2(/*+/

J"&I'(-(F'%&".#"(,".#&*(-(,'_-*(3-( S('3K&.&,#*'MN-(3"('/5:.,(
'/&K".#-("(%-K(&,,-(F-3"(F"*K&#&*('( K"3&%'K".#-,(F-3"(,"*(K'&,(
F-,,&_&/&3'3"(3"(F"Y:".-,(F*'j"*", #*'_'/1-,'

<-*#'/"%"(-(7$.%:/-('V"#&7-(".#*"(
F'%&".#"("(,":,(%:&3'3-*",P(F-&,('(
'/&K".#'MN-(3"(%-.V-*#-(c(:K'(
V-*K'(3"(%'*&.1-

11
 Alimentação por Sonda
k( Y:'.3-( '( '/&K".#'MN-( c( -V"*"%&3'( '#*'7c,( 3"(
:K( #:_-( 3"( K'#"*&'/( F/i,#&%-( e'( ,-.3'f( Y:"( c(
%-/-%'3-( 3".#*-( 3-( ",#mK'5-( 3-( F'%&".#"G(
J",,'( V-*K'P( :K( %:&3'3-*( %-.,"5:"( %-/-%'*( -(
'/&K".#-P( i5:'( "( K"3&%'K".#-,( F"/'( ,-.3'( .-(
",#mK'5-( 3-( F'%&".#"P( ,"K( Y:"( "/"( F*"%&,"(
K',#&5'*(-:(".5-/&*(-('/&K".#-G(

S( ,-.3',( Y:"( F-3"K( ,"*( :,'3',( .",,"( %',-( ,N-(

3"(3-&,(#&F-,;

(K-.3'( .',-5L,#*&%'C( :K( #:_-( c( F',,'3-( F"/-( .'*&j( 3-( F'%&".#"( '#c( %1"5'*(
.-( ",#mK'5-G( >K'( 3',( F-.#',( 3'( ,-.3'( H%'( 3-( /'3-( 3"( V-*'( 3-( .'*&j( 3-(
F'%&".#"("('(-:#*'(F-.#'(H%'(3".#*-(3-(,":(",#mK'5-G

()',#*-,#-9&'C(:K(#:_-(c(F',,'3-(3&*"#'K".#"('#*'7c,(3'(F"/"(3'(_'**&5'(3-(
F'%&".#"G(>K'(F-.#'(c(%-/-%'3'(3".#*-(3-(",#mK'5-("(-:#*'(3-(/'3-(3"(V-*'(
3'(_'**&5'G(

!"#$%&"&'%#("&#"'%)*'$+,-"&-%.%&"&)"'$+%'$%.,"&'/+0/.&1"+"&23/&"&1/''%"&1%''"&
+/-/4/+&'3"&"5,./#$"67%8&5923,(%'&/&./(,-"./#$%':
( S( ,-.3'( .',-5i,#*&%'( .-*K'/K".#"( 3"7"( ,"*( :,'3'( F-*( F-:%-( #"KF-P(
5"*'/K".#"(.N-(K'&,(3-(Y:"(R(,"K'.',P(F-*Y:"(,":(:,-(F-*(K'&,(#"KF-(F-3"(%':,'*(
V"*&3',( .-( .'*&jP( &.n'K'MN-( .'( 5'*5'.#'P( ",#".-,"( ",-Vi5&%'( eY:'.3-( -%-**"( '(
3&K&.:&MN-( 3'( /'*5:*'( 3-( ",mV'5-fP( ,'.5*'K".#-( .-( ",mV'5-( -:( ",#mK'5-P( "(
*-:Y:&3N-G

( S( V-*K'( 3'( 3&"#'( Y:"( ,"*i( '3K&.&,#*'3'( '#*'7c,( 3',( ,-.3',( c( :K'( '/&K".#'MN-(
/$Y:&3'( "( -,( K"3&%'K".#-,( F*"%&,'K( ,"*( 3&,,-/7&3-,( F'*'( ,"*"K( 'F/&%'3-,( '#*'7c,(
3"/',G

( S/5:.,( K"3&%'K".#-,( .N-( F-3"K( ,"*( 'F/&%'3-,( '#*'7c,( 3"( ,-.3',G( A-*( &,,-P(
F*-H,,&-.'&,(3"(,'T3"(3"7"K(,"*(%-.,:/#'3-,(,-_*"(Y:'&,(K"3&%'K".#-,(F-3"K(,"*(
'F/&%'3-,(F-*(,-.3',("(Y:'&,(.N-(F-3"KG
12
 VANTAGENS E DESVANTAGENS DA
ALIMENTAÇÃO POR SONDA

VANTAGENS DESVANTAGENS
A-3"(%':,'*(3",%-.V-*#-('-(F'%&".#"P(
)'*'.#"(-(-V"*"%&K".#-(3"(
/"7'.3-8-('(#".#'*(#&*'*('(,-.3'P(-(Y:"(
%'/-*&',("(.:#*&".#",("K(
F-*(,:'(7"j(F-3"(/"7'*('(-:#*',(K"3&3',(
Y:'.#&3'3",(F'3*-.&j'3',
Y:"(%':,'K(K'&,(,-V*&K".#-P(%-K-(
'K'**'*(,":,(_*'M-,(.'(%'K'

S(,-.3'(F-3"('F*",".#'*(%-KF/&%'Mb",G(
A-*("I"KF/-P(F-3"K(-%-**"*(7'j'K".#-P(
6"+/'1%".#"&/$/(45%"1%./" &.V"%Mb",P(".#:F&K".#-(-:(
)/&"'/*%&"/"/7(8/"'/*%)"
/)$%&4%".%)"2,(.#.%&/) 3",/-%'K".#-,P(Y:"(F-*(,:'(7"j(
V*"Y:".#"K".#"(F-3"*N-(/"7'*('(7&,&#',('(
,"*7&M-,(3"(F*-.#-(,-%-**-

((((((((((((((((((((((((((((((((((((((((((
A-3"(V'j"*(%-K(-(Y:"(-(F'%&".#"(HY:"(
K'&,(F'*'3-(.'(%'K'P(%-.#*&_:&.3-(F'*'(
'(V-*K'MN-(3"(V"*&3',(3"(F"/"((((((((((((((
((((((((((((((((((((((((((((((((((((((((((
A-3"(%':,'*('5&#'MN-(.-(F'%&".#"

A'%&".#"(.N-(,".#"(-(,'_-*(3-('/&K".#-

13
 QUAL A MELHOR
OPÇÃO?

J&7"*,',( ,-%&"3'3",( 3'( i*"'( 3'( ,'T3"( *"%-K".3'K( Y:"P( 3"( V-*K'( 5"*'/P( ,"`'(
3'3'(F*"V"*L.%&'(a('/&K".#'MN-(3"(%-.V-*#-("(Y:"('('/&K".#'MN-(F-*(,-.3'(,"`'(
"7&#'3'( "K( F'%&".#",( %-K( 3"KL.%&'( "K( V',"( '7'.M'3'G( 2,,'( *"%-K".3'MN-( ,"(
3"7"('(:K'('7'/&'MN-(%*&#"*&-,'(3-(%-.1"%&K".#-(%&".#$H%-(,-_*"(",,"(',,:.#-P('(
Y:'/( &.3&%'( Y:"( '( *"/'MN-( *&,%-8_"."V$%&-( 3'( '/&K".#'MN-( 3"( %-.V-*#-( c( K'&,(
V'7-*i7"/(Y:"('(3'('/&K".#'MN-(F-*(,-.3'(F'*'(",,",(F'%&".#",G

?-( ".#'.#-P( 1i( ,&#:'Mb",( "K( Y:"( -,( 7'/-*",( %:/#:*'&,( 3"( F'%&".#",( "( ,":,(
V'K&/&'*",( 3N-( F*"V"*L.%&'( a( '/&K".#'MN-( F-*( ,-.3'( K",K-( V*".#"( a(
%-KF*"".,N-( 3"( Y:"P( 3"( '%-*3-( %-K( -( K"/1-*( %-.1"%&K".#-( %&".#$H%-( '#:'/P(
",,'( 7&'( 3"( '/&K".#'MN-( F-3"( ,"*( ',,-%&'3'( '( :K'( K'&-*( V*"Y:L.%&'( 3"(
%-KF/&%'Mb",G( ?",,',( ,&#:'Mb",( ",F"%$H%',( '( '/&K".#'MN-( F-*( ,-.3'( F-3"( ,"*(
'%"&#i7"/( %-K-( :K'( ",#*'#c5&'( F'*'( "7&#'*( -( ,-V*&K".#-( Y:"( -%-**"*&'( %',-( -,(
7'/-*",(3",,",(F'%&".#",("(,":,(V'K&/&'*",(.N-(V-,,"K(*",F"&#'3-,G

A-*#'.#-P('(3"%&,N-("K(*"/'MN-('(%-K-('/&K".#'*(:K(F'%&".#"(%-K(3"KL.%&'("K(
V',"('7'.M'3'(3"7"(,"*(#-K'3'(3"(V-*K'(&.3&7&3:'/&j'3'("(%-KF'*#&/1'3'(".#*"(
F*-H,,&-.'&,( 3"( ,'T3"( "( -,( *"F*",".#'.#",( 3-,( F'%&".#",P( /"7'.3-( "K(
%-.,&3"*'MN-(#'.#-(-,(%-.1"%&K".#-,(%&".#$H%-,(%-K-(-,(
7'/-*",(3-(F'%&".#"("(3"(,:'(V'K$/&'G

6,( V'K&/&'*",( 3-,( F'%&".#",( 3"7"K( #"*(

,"5:*'.M'( 3"( Y:"( ",,',( 3"%&,b",( F-3"K( ,"*(
*"7&,#',( ,"KF*"( Y:"( ."%",,i*&-( "( Y:"( #-3-,( -,(
F*-H,,&-.'&,(3"(,'T3"(F-,,:"K(-(%-KF*-K&,,-(c#&%-(3"(
_:,%'*( -( '/$7&-( 3-( ,-V*&K".#-( 3-,( F'%&".#",( "( 3"( ,":,(
V'K&/&'*",G
 MITOS SOBRE A
ALIMENTAÇÃO POR
SONDA PARA
PACIENTES COM
DEMÊNCIA EM FASE
AVANÇADA
 MITOS SOBRE A ALIMENTAÇÃO POR
SONDA PARA PACIENTES COM
DEMÊNCIA EM FASE AVANÇADA

O uso da sonda protege contra a aspiração?

F;-G( =",K-( :,'.3-( '( ,-.3'P( -( F'%&".#"( F-3"( ',F&*'*( ,'/&7'( "( '/&K".#-( F-*(
*"n:I-P(Y:"(c(Y:'.3-(-('/&K".#-(7-/#'(3-(",#mK'5-(F'*'(-(",mV'5-P("(F-3"(
'#c(%1"5'*(a(_-%'(3-(F'%&".#"G

A alimentação recebida por sonda protege ou ajuda na

melhora de lesões por pressão, que são feridas na pele
que se formam quando o paciente fica muito tempo na
cama sem se movimentar e na mesma posição?
F;-G(S,(F",Y:&,',(K-,#*'K(Y:"(',(/",b",(3"(F"/"(F-*(F*",,N-(.N-(K"/1-*'K(
%-K(-(:,-(3',(,-.3',G(A"/-(%-.#*i*&-P(%-K(-(:,-(3'(,-.3'('(F",,-'(%-,#:K'(
H%'*(K'&,(F'*'3'(.'(%'K'P(-(Y:"(5"*'/K".#"(%':,'(-('F'*"%&K".#-(-:('(F&-*'(
3"(/",b",(3"(F"/"(F-*(F*",,N-G

16
Usar a sonda está ligado à prevenção de hospitalizações
ou idas a serviços de urgência?
F;-G(2,#:3-,(K-,#*'K(Y:"(-(:,-(3"(,-.3',(3"('/&K".#'MN-("K(F'%&".#",(%-K(
3"KL.%&'( "K( V',"( '7'.M'3'( c( ',,-%&'3-( '( :K( K'&-*( .TK"*-( 3"( 7&,&#',( '(
,"*7&M-,(3"(F*-.#-(,-%-**-(3-(Y:"(Y:'.3-(-,(F'%&".#",(.N-(:,'K(,-.3',G(4,,-(
-%-**"( F-*Y:"( Y:'.3-( '( ,-.3'( H%'( ".#:F&3'( -:( ,'&( 3-( /:5'*P( '( V'K$/&'(
V*"Y:".#"K".#"('%'_'(F*"%&,'.3-(/"7'*(-(F'%&".#"('-(1-,F&#'/(F'*'(*",-/7"*(-(
F*-_/"K'(%-K('(,-.3'(-:(K",K-(#*-%i8/'G(

O paciente fica mais confortável com uso da sonda?

F;-G( A'*'( K:&#-,( F'%&".#",P( '( ,-.3'P( F*&.%&F'/K".#"( '( ,-.3'( .',-5i,#*&%'P(
F-3"(%':,'*(&.%mK-3-("(3",%-.V-*#-P(/"7'.3-('(F",,-'('(H%'*('5&#'3'G(=:&#',(
7"j",(-,(F'%&".#",(,N-('K'**'3-,(.'(%'K'(F'*'(&KF"3&*(Y:"("/",('**'.Y:"K('(
,-.3'P(-(Y:"(V*"Y:".#"K".#"(V'j(%-K(Y:"("/",(HY:"K(K'&,(3",%-.V-*#i7"&,(
'&.3'(F-*(",#'*"K('K'**'3-,G

O paciente que recebe alimentação por sonda vive

mais?
F;-G(2,#:3-,(*"'/&j'3-,(%-K(F",,-',(%-K(3"KL.%&'("K(V',"('7'.M'3'("(%-K(
3&H%:/3'3",( F'*'( ,"( '/&K".#'*( -:( ".5-/&*( K-,#*'K( Y:"( F'%&".#",( "K( :,-( 3'(
,-.3'( .N-( 7&7"K( K'&,( Y:'.3-( %-KF'*'3-,( %-K( F",,-',( %-K( 3"KL.%&'(
'7'.M'3'(Y:"(*"%"_"*'K('/&K".#'MN-(3"(%-.V-*#-G(

17
 O QUE FAZER SE O PACIENTE NÃO PUDER
RECEBER ALIMENTO PELA BOCA?
h( 0-K( -( '7'.M-( 3'( 3"KL.%&'P( -( F'%&".#"( F-3"( .N-( %-.,"5:&*( K'&,( ,"( '/&K".#'*(
F"/'(_-%'P(F-*( (.N-(%-.,"5:&*(K'&,(".5-/&*G(?",,"(K-K".#-(:K'('7'/&'MN-(Kc3&%'(c(
&KF-*#'.#"( F'*'( 3"#"*K&.'*( ,"( *"'/K".#"( c( '( 3"KL.%&'( "K( V',"( '7'.M'3'( Y:"( ",#i(
%':,'.3-( ",,'( ,&#:'MN-( -:( ,"( -:#*',( %':,',( F-3"K( ",#'*( ".7-/7&3',P( %-K-( F-*(
"I"KF/-P(&.V"%Mb",(-:("V"&#-,(%-/'#"*'&,(3"(K"3&%'K".#-,G

h( d:'.3-( :K( F'%&".#"( %-K( 3"KL.%&'( 'F*",".#'( 3&H%:/3'3"( F'*'( ,"*( '/&K".#'3-(
F-*Y:"( ",#i( "K( V',"( '7'.M'3'( 3'( 3"KL.%&'P( &,,-( Y:"*( 3&j"*( Y:"( "/"( F-3"( ",#'*( ,"(
'F*-I&K'.3-( 3-( HK( 3'( ,:'( 7&3'G( ?",,'( V',"P( .".1:K( #*'#'K".#-( Kc3&%-( -:(
.:#*&%&-.'/(F-3"(V'j"*(%-K(Y:"(-(F'%&".#"(*"#-*."(F'*'(V',",(K'&,(/"7",(3'(3"KL.%&'G

h( J"&I'*(3"(%-K"*("(_"_"*(V'j(F'*#"(3-(F*-%",,-(.'#:*'/(3"(K-*#"(.'(K'&-*&'(3',(
3-".M',G( ?'( 7"*3'3"P( -( `"`:K( F*-/-.5'3-( "( '( 3",&3*'#'MN-( ,N-( .-*K'&,( .",,"(
K-K".#-( "( F-3"K( '#c( K",K-( F*-#"5"*( -( F'%&".#"( 3-( ,-V*&K".#-( '-( F*-7-%'*(
,-.-/L.%&'G(0-K-(,"('(,'_"3-*&'(3"(,":(F*gF*&-(%-*F-(",#&7",,"(%-/'_-*'.3-(F'*'(Y:"(
-(F'%&".#"(3-*K&,,"("(.N-(,-V*",,"(3",%-.V-*#-,G(

h( d:'.3-( ',( F",,-',( ",#N-( K:&#-( F*gI&K',( '-( HK( 3'( 7&3'( "/',( %-,#:K'K( .N-(
,".#&*(V-K"(-:(,"3"G(<-*M'*(-(%-.,:K-(3"('/&K".#-,('#*'7c,(3'(_-%'(-:(F-*(,-.3',(
F-3"( %':,'*( 3",%-.V-*#-( 3",."%",,i*&-P( F-*Y:"( -,( F'%&".#",( F-3"K( 'F*",".#'*(
.i:,"'("(7mK&#-,P('/cK(3"(-:#*-,(,&.#-K',P("(F*-/-.5'*(-(F*-%",,-(.'#:*'/(3"(K-*#"G(

h( 2K( #-3-,( -,( %',-,( -,( F*-H,,&-.'&,( 3"( ,'T3"( 3"7"K( %-.7"*,'*( %-K( '( V'K$/&'( 3-(
F'%&".#"(,-_*"(-,(-_`"#&7-,(3"(%:&3'3-,(3"(%'3'(F'%&".#"("IF*",,-,(7"*_'/K".#"("^-:(
*"5&,#*'3-,( F*"7&'K".#"( "K( F*-.#:i*&-,( Kc3&%-,( "( 3&*"#&7',( '.#"%&<'3',( 3"(
7-.#'3"MG( (J"7"K( (,"KF*"(*"'/&j'*(#-3-,(-,(",%/'*"%&K".#-,(,-_*"(F-,,$7"&,(*&,%-,("(
_"."V$%&-,( 3"( Y:'/Y:"*( K"3&3'G( d:'.3-( -( F'%&".#"( .N-( K'.&V",#-:( '.#"*&-*K".#"(
,:',(F*"V"*L.%&',(3"(%:&3'3-P(-,(F*-H,,&-.'&,(3"(,'T3"(3"7"K('`:3'*('(V'K$/&'('(#".#'*(
/"7'.#'*(",,',(Y:",#b",('#*'7c,(3"(:K'(%-.7"*,'(,-_*"(,:'(1&,#g*&'(3"(7&3'P(7'/-*",("(
F*"V"*L.%&',G( J",,"( K-3-P( ",F"*'8,"( Y:"( `:.#-,P( F*-H,,&-.'&,( 3"( ,'T3"( "( -,(
*"F*",".#'.#",(3-(F'%&".#"(F-,,'K(#-K'*(3"%&,b",(,-_*"(%:&3'3-,(3"(,'T3"(Y:"('-(
K",K-(#"KF-(*",F"&#"K(,":,(7'/-*",(F",,-'&,("(,"`'K('3"Y:'3',(F'*'(,:'(,&#:'MN-G

M(N&*"#&7',('.#"%&<'3',(3"(7-.#'3"(,N-(3-%:K".#-,(V"&#-,(F"/-(F'%&".#"(.'(cF-%'("K(Y:"(-(K",K-('&.3'("*'(%'F'j(3"(
3"%&3&*(F-*(,&(K",K-("(Y:"("IF*",,'K(Y:'&,(#*'#'K".#-,(3"(,'T3"("/"(5-,#'*&'(-:(.N-(3"(*"%"_"*("K(,&#:'Mb",(V:#:*',(
"K(Y:"(.N-(K'&,(%-.,"5:&,,"(%-K:.&%'*8,"('3"Y:'3'K".#"(-:(3"%&3&*(F-*(,&(,gG
E agora, o que fazer na prática com o que aprendi?
@"( 7-%L( -:7&:( 3"( :K( F*-H,,&-.'/( 3"( ,'T3"( Y:"( ,":( V'K&/&'*( -:( F",,-'( Y:"*&3'(
F-,,:&( :K'( 3"KL.%&'( "K( V',"( '7'.M'3'P( -:( 7-%L( ,:,F"&#'( Y:"( ,":( V'K&/&'*( ,"(
".%-.#*"( "K( :K'( V',"( '7'.M'3'( 3"( 3"KL.%&'P( &.&%&"( :K'( %-.7"*,'( %-K( -,(
F*-H,,&-.'&,( 3"( ,'T3"( Y:"( %:&3'K( 3-( F'%&".#"( ,-_*"( ,:',( F*"-%:F'Mb",( "(
3T7&3',(Y:'.#-(a('/&K".#'MN-("(-,(%:&3'3-,(3"(,'T3"(3-(F'%&".#"G(

4.V"/&jK".#"P(."K(,"KF*"(-,(F*-H,,&-.'&,(3"(,'T3"(&.&%&'K(",,"(#&F-(3"(%-.7"*,'G(
A-*( &,,-P( Y:'.3-( 7-%L( #-K'( '( &.&%&'#&7'( 3"( %-K"M'*( ",,'( %-.7"*,'P( &,,-( F-3"(
3&K&.:&*('(%1'.%"(3"(Y:"("/'('%-.#"M'('F".',("K(:K'(,&#:'MN-(3"(:*5L.%&'(eF-*(
"I"KF/-P( 3:*'.#"( :K'( F.":K-.&'f( Y:'.3-( F-3"( ,"*( K'&,( 3&V$%&/( #-K'*( :K'(
3"%&,N-("Y:&/&_*'3'G

A*-%:*"(3",%-_*&*(,"(-(F'%&".#"(3"&I-:('/5:K'(-*&".#'MN-(7"*_'/(-:(",%*&#'(,-_*"(
%-K-(5-,#'*&'(3"(,"*(%:&3'3-(%',-(:K(3&'(",#&7",,"("K(:K(",#'3-(3"(,'T3"(3"(
#-#'/(3"F".3L.%&'(%-K-("K(:K'(3"KL.%&'('7'.M'3'G

A".,"( "( %-.7"*,"( %-K( -:#*',( F",,-',( Y:"*&3',( 3-( F'%&".#"( ,-_*"( %-K-( 7-%L,(
'%*"3&#'K(Y:"("/"(5-,#'*&'(3"(,"*(%:&3'3-("K(,:'(,&#:'MN-('#:'/(3"(,'T3"P(%',-(
V-,,"( %'F'j( 3"( ,"( %-K:.&%'*( 3"( V-*K'( "V"#&7'G( A".,"K( ,-_*"( -( #&F-( 3"( F",,-'(
Y:"("/"("*'('.#",(3"(3",".7-/7"*('(3"KL.%&'("(-(Y:"(7-%L,('%*"3&#'K(Y:"(,"*&'K(
',(%-&,',(K'&,(&KF-*#'.#",(F'*'("/"("(',(%-&,',(Y:"("/"(5-,#'*&'("(.N-(5-,#'*&'(Y:"(
V-,,"K(V"&#',(%-K("/"G(A".,'*(,-_*"(&,,-(&*i('`:3'*(_',#'.#"(.'(#-K'3'(3"(3"%&,N-(
,-_*"(-,(%:&3'3-,(3"(,'T3"(3-(F'%&".#"(%-K(-,(F*-H,,&-.'&,(3"(,'T3"G(

19
Palavras finais...
h( k( F*-7i7"/( Y:"( ",,"( 5:&'( .N-( #".1'( *",F-.3&3-( #-3',( ',( ,:',( 3T7&3',G( J"( %"*#'(
V-*K'(&,,-(c(",F"*'3-P(F-&,(.-,,-(-_`"#&7-(.N-(c(-(3"(,:_,#&#:&*('Y:&/-(Y:"('%1'K-,(
K'&,(&KF-*#'.#"P(Y:"(c('(%-.7"*,'("(-(*"/'%&-.'K".#-(".#*"(-,(F*-H,,&-.'&,(3"(,'T3"(
"(,":,(F'%&".#",P(V'K&/&'*",("(%:&3'3-*",G

h( ]-3',( ',( 3"%&,b",( F*"%&,'K( ,"*( F".,'3',( F'*'( %'3'(

F'%&".#"G(6(Y:"(V-&('3"Y:'3-(F'*'(:K(F'%&".#"("(:K'(
V'K$/&'( F-3"( .N-( ,"*( '3"Y:'3-( F'*'( -:#*-(
F'%&".#"("(-:#*'(V'K$/&'G(

h( 2,F"*'K-,( Y:"( ',( &.V-*K'Mb",(

V-*."%&3',( '#*'7c,( 3",,"( K'#"*&'/(
,"`'K( T#"&,( F'*'( ':K".#'*( -(
% - . 1 " % & K " . # -( , - _ * "( ' ,(
- F M b " ,( 3 "( K ' . " ` -( 3 '(
.:#*&MN-( "K( F'%&".#",(
%-K( 3"KL.%&'( "K( V',"(
'7'.M'3'G

h( 2,F"*'K-,( '&.3'P(
Y : "( " , , "( . - 7 -(
%-.1"%&K".#-( F-,,'(
# - * . ' *( K ' & ,( V i % " & ,(
%-.7"*,',( 3"( V'K&/&'*",(
"( %:&3'3-*",( %-K( -,(
F*-H,,&-.'&,(3"(,'T3"(3"(
K-3-('(%-.#*&_:&*(F'*'(',(
K " / 1 - * " ,( 3 " % & , b " ,(
F - , , $ 7 " & ,( Y : ' . # -( ' - ,(
%:&3'3-,( 3"( ,'T3"( 3",,",(
F'%&".#",G
20
Referências
9-#8(#:&();*#*0"<=0">;#*?(0"@=9=0"<,&(#*"A="BC#-,#D%*"#*."'#*#8/'/*+"%$"%&%1;#&E*8/#-"
.E)1;#8(#" (*" .(F/&/*+" +E1/)" %$" ./'/*D#G" 9" )E)+/'#D2" &/C(/H=" 9&2;(C/)" %$" I/&%*+%-%8E"
#*."I/&(#+&(2)"="B-)/C(/&"J&/-#*."K+.="LMNOPQRG"NST="
9'/&(2#*" I/&(#+&(2)" U%2(/+E" B+;(2)" V%''(W//" #*." V-(*(2#-" X&#2D2/" #*." A%./-)" %$" V#&/"
V%''(W//=" 9'/&(2#*" I/&(#+&(2)" U%2(/+E" $//.(*8" +,3/)" (*" #.C#*2/." ./'/*D#" 1%)(D%*"
)+#+/'/*+="Y"9'"I/&(#+&"U%2="LMNZPRL[\]GNQTMSO="
>&#,*/&0" " ^=Y=" @/2%*)(./&(*8" ^/$#,-+" A/.(2(*/=" _;/" 9'/&(2#*" I/&(#+&(2)" U%2(/+E=" LMNMP"
Q\GQTTSRMN=
V/&C%0" `=9=0" >&E#*0" K=0" `#&3/&0" U=" _%" XBI" %&" *%+" +%" XBI=" " 9" &/C(/H" %$" /C(./*2/" $%&" 1-#2(*8"
$//.(*8" +,3/)" (*" #.C#*2/." ./'/*D#" #*." +;/" ./2()(%*a'#:(*8" 1&%2/))=" I/&(#+&(2)=""
LMMRPRN[R]GOMaOQ=
V-#&:/0"I=0"/+"#-="b%H"#&/"+&/#+'/*+"./2()(%*)"'#./"#3%,+"#&Dc2(#-"*,+&(D%*"$%&"(*.(C(.,#-)"
#+"&():"%$"-#2:(*8"2#1#2(+Ed"9")E)+/'#D2"-(+/&#+,&/"&/C(/H="X-%)"6*/="LMNOP"\[Z]GNa\=
B)e,fC/-0"U=0"U#'1#(%0"Y=`=0"U(-C#0"V=_="9-('/*+#&"#"C(.#"%,"),)+/*+#&"#"'%&+/d"g'#"&/h/75%"
/'"/e,(1#"1#&D*.%"./",'"2#)%"2-f*(2%="@/C"X%&+"A/."I/&#-"`#'="LMNZPOMGZZ"aZT=
`(*,2#*/0"_=B=0"V;&()+'#)0"V=0"_&#C()0"<="_,3/"$//.(*8"(*"1#D/*+)"H(+;"#.C#*2/."./'/*D#0"#"
&/C(/H"%$"+;/"/C(./*2/="9'/&(2#*"A/.(2#-"9))%2(#D%*="NTTTPNZ[L\L]G"NORQaiM=
`(*,2#*/0" _=B=0" /+" #-=" _,3/" `//.(*8" (*" ^/'/*D#G" b%H" J*2/*DC/)" g*./&'(*/" b/#-+;" V#&/"
j,#-(+E"#*."X#D/*+"U#$/+E="9'/&(2#*"A/.(2#-"^(&/2+%&)"9))%2(#D%*="LMMiP\G"LMQSM\=
I#&&%H0"^=0"X&(./0"X=0"A%&#*0"k=0"l#1:#0"Y=0"9'/--#0"B=0"^/-/88/0"A="`//.(*8"#-+/&*#DC/)"(*"
1#D/*+)" H(+;" ./'/*D#G" /7#'(*(*8" +;/" /C(./*2/=" V-(*(2#-" I#)+&%/*+/&%-%8E" #*."
;/1#+%-%8E="LMMiPQGNOiLSi\=
b#*)%*0" K=V=0" B&)/:0" A=0" I(--(#'0" @" =0" V#&/E0" _U=" " 6&#-" $//.(*8" %1D%*)" $%&" X#D/*+)" H(+;"
^/'/*D#G"#")E)+/'#D2"&/C(/H="Y"9'"I/&(#+&"U%2="LMNNPQT[O]G"ZROSiL=
Y%*/)#0" B=k=0" " <#-.?(#*30" K=V=0" `%&'#*ab%F'#*#0" m=" `#2+%&)" #))%2(#+/." H(+;" 8#)+&%)+%'E"
+,3/" $//.(*8" (*" ./'/*D#G" 9" )+&,2+,&/." -(+/&#+,&/" &/C(/H=" " _;/" 9-n;/('/&o)" 9))%2(#D%*="
LMMR="1="LOZaZL=
A#&:0"b=0"^/K/880"A=b=0"/+"#-="B+;(2#-"#*."'/.(2%-/8#-"#)1/2+)"%$"XBIa+,3/"1-#2/'/*+"#*."
1&%C()(%*"%$"#&Dc2(#-"*,+&(D%*#-"+;/&#1E="I#)+&%(*+/)D*#-"B*.%)2%1E="LMMQPRL"[R]G"TQLaQT=
A22-#C/0" 9=U=0" V;#*80" k=<=" V%'1-(2#D%*)" %$" /*+/&#-" #22/))=" I#)+&%(*+/)D*#-" /*.%)2%1E="
LMMOPQ\"[Q]GiOTaQN=
A,&(/-0" @=0" I(--(2:0" A=^=" @/+;(*:(*8" +;/" @%-/" %$" _,3/" `//.(*8" (*" X#D/*+)" H(+;" 9.C#*2/."
^/'/*D#=" _;/" p/H" B*8-#*." Y%,&*#-" %$" A/.(2(*/0" A#))#2;,)/W)" A/.(2#-" U%2(/+E=" " LMMMP"
OZLGLMRaNM="

X#-/2/:0" B=Y=0" /+" #-=" V%'$%&+" $//.(*8" %*-EG" #" 1&%1%)#-" +%" 3&(*8" 2-#&(+E" +%" ./2()(%*a" '#:(*8"
&/8#&.(*8" .(q2,-+E" H(+;" /#D*8" $%&" 1/&)%*)" H(+;" #.C#*2/." ./'/*D#=" _;/" 9'/&(2#*"
I/&(#+&(2)"U%2(/+E="LMNMPQ\GQ\MS\Z="

X&(*2/0" A=Y=" k%&-." 9-n;/('/&" @/1%&+=" _;/" I-%3#-" J'1#2+" %$" ^/'/*D#=" LMNQ=" ^()1%*fC/-"
/'G";W1)GrrHHH=#-n=2%=,:r&/)/#&2;rH%&-.a&/1%&+aLMNQ

U#'1)%*0" B=K=0" V#*.E0" >=0" K%,()/0" Y=" B*+/&#-" +,3/" $//.(*8" $%&" %-./&" 1/%1-/" H(+;" #.C#*2/."
./'/*D#=V%2;&#*/" ^#+#3#)/" %$" UE)+/'#D2" @/C(/H)=" J*G" _;/" V%2;&#*/" K(3&#&E0" LMNZP[\]="
U'(+;0"b=9=0"<(*./--0"Y=0">#-.H(*0"@=V=0"k#+/&'#*0"^=0"A#:(*0"9=Y="UH#--%H(*8"1&%3-/')"#*."
./'/*D#"(*"#2,+/";%)1(+#-")/s*8)G"1&#2D2#-"8,(.#*2/"$%&"+;/"'#*#8/'/*+"%$".E)1;#8(#="
V-(*(2#-"A/.(2(*/=""LMMTPT[R]GQZZaZ\=

_/*%0" Y=A=0" A(+2;/--0" U=K=0" <,%0" U=<=0" I%n#-%0" X=K=0" @;%./)0" @=K=0" K('#0" Y=V=0" A%&0" m="
^/2()(%*aA#:(*8" #*." 6,+2%'/)" %$" `//.(*8" _,3/" J*)/&D%*G" 9" `(C/aU+#+/" U+,.E=" " Y%,&*#-"
2%'1(-#D%*0"_;/"9'/&(2#*"I/&(#+&(2)"U%2(/+E="LMNPQTG"\\Na\R=

m(.#-0"B=J=6P"/+"#-="X%)(2(%*#'/*+%"9pVXG"p,+&(45%"/";(.&#+#45%"/'"1#2(/*+/)"1%&+#.%&/)"./"
./'t*2(#"/'"$#)/"#C#*4#.#"u-(C&%"/-/+&v*(2%wG"2%'(+t"./"3(%xD2#".#"#2#./'(#"*#2(%*#-"./"
2 , ( . # . % )" 1 # - ( # DC % ) =" N # =" / . ( 4 5 % =" L M L M =" ^ ( ) 1 % * f C / -" / ' G"
;W1)Grr#1(aH%&.1&/))=1#-(#DC%=%&8=3&rH1a2%*+/*+r,1-%#.)rLMLMrNLrX6UJVJ6p9ABp_6ap
,+&(2#%a/a;(.&#+#2#%a/'a1#2(/*+/)a1%&+#.%&/)a./a./'/*2(#a/'a$#)/a#C#*2#.#c*#-=1.$

m(+#-/0" V=9=0" /+" #-=" _,3/" $//.(*8" (*" 1#D/*+)" H(+;" #.C#*2/." ./'/*D#G" :*%H-/.8/" #*."
1&#2D2/" %$" )1//2;a-#*8,#8/" 1#+;%-%8()+)=" Y%,&*#-" %$" X#(*" #*." UE'1+%'" A#*#8/'/*+="
LMNNPZL[O]GORRai\=