The increasing size and longevity of the geriatric patient population dictates that all health care practitioners become more cognizant ofthe unique requirements for nutritional assessment and support of the elderly. This review summarizes recent advances in the understanding of the nutrition support needs of the old and oldest-old patients requiring enteral or parenteral feeding. When a nutrition support formula individualized for the geriatric patient is being developed, there is a fine line between excess and deficit, requiring the involvement of the entire support team in monitoring the success of feeding. Indications for choosing enteral or parenteral feeding are considered excessively invasive by some and necessarily "heroic" by others. The patient and his or her family should be part of the decision-making process.
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