A 78-Year-Old Man with Parkinson's Disease Is Being Cared for in a Nursing

Multiple Choice

A 78-year-old man with Parkinson's disease is being cared for in a nursing home.The nurses observe that he coughs at mealtime;he has the ability to still feed himself with adaptive equipment.He has had no aspirations.Oral exam is normal,except during his swallowing assessment you note there is slight delayed elicitation.You assess that he has only mild dysphagia.You recommend which of the following as the next step in his care?

A) Consult gastroenterologist for g-tube decision
B) Consult speech pathologist for video fluoroscopy
C) Provide a trial of foods of differing consistency
D) Require that he is fed all his meals