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AD.14. Sithara Jayathunga - Ms Julia Smith


The Dietitian

Department of Nutrition and Dietetics

Spirit Hospital

Prayertown NSW 2175

15 October 2019

Dear Dietitian.

Re: Ms Julia Smith, DOB: 6 November 1951

Ms Julia Smith, who has been increased the risk of aspiration due to dementia, requires immediate assessment of swallowing function and nutritional aspects.

Whilst in our care, Ms Smith choked on a poorly chewed piece of food yesterday followed by sudden onset cyanosis, vital changes along with cough were observed. Subsequently, the food particle was removed and then remained stable.

Recently, she has been experiencing throat clearing following consumed yoghurt. As a result of confusion and disorientation. Refraining from wear dentures is noticed. In addition to that, accelerated appetite has been observed. In relation to that, weight gain of ten kilograms is reported with the present weight of 106 kg as well as body mass index of thirty. There are no allergies related to the drugs or food.

Ms Smith is diabetic for the last twelve years, which has been controlled by diet. Additionally, she has been treated for ischemic heart disease since 2012 and chronic constipation, for which she currently takes Nitroglycerine patch in daily basis and laxatives when needed respectively. She also had a history of stroke in 2018 as well as dyspnea and cough at times.

Based on the aforementioned circumstances, expert evaluation and appropriate dietary management would be extremely beneficial for improving Ms Smith’s nutritional status and preventing further risk of aspiration.

If any additional information is required, please do not hesitate to contact me.

Yours faithfully,

Registered Nurse

Dementia Specific Unit



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