Feeding Tubes Not Recommended for Patients with Dementia

Nursing home patients suffering from advanced dementia should be sustained through careful hand feeding in order to avoid potential serious health problems associated with gastric feeding tubes.

That is the position taken by the American Geriatrics Society (AGS).13722035422az6r

A  Naples personal injury attorney experienced in elder care knows the nursing industry suffers from an over-reliance on feeding tubes, which can result in a variety of medical complications.

Nursing home residents suffering from advanced dementia generally experience eating difficulties apart from the loss of memory, speech and other functions.

Nursing homes typically encourage the placement of gastric feeding tubes in dementia patients with acute eating problems because hand-feeding is more time-consuming for staff. Called percutaneous endoscopic gastrostomy (PEG), the procedure involves the insertion of a feeding tube through the skin of the abdomen and into the stomach.

You must understand that the insertion of a gastric feeding tube is a medical procedure that entails a risk of complications and requires informed consent by the patient or their caregiver. All too often, the families of patients with dementia find themselves pressured to consent to tube feeding without a full discussion of the alternatives.

Given these facts, it is not surprising that approximately 34 percent of U.S. nursing home patients with advanced dementia have feeding tubes.

But the AGS has concluded in a position paper that the evidence does not support the use of a feeding tube when hand feeding is an available alternative.

To the contrary, “studies consistently demonstrate a very high mortality in older adults with advanced dementia who have feeding tubes.”

The loved ones of nursing home patients should understand the serious health problems associated with tube feeding.

Patients with feeding tubes often have been found to suffer from infection, worsening pressure ulcers and pressure wounds. Feeding tubes are also associated with an increase in the level of agitation experienced by a patient with dementia.

In addition to the risk of tube malfunction, tube feeding is also often associated with the increased use of physical and chemical restraints against the patient.

Moreover, studies have revealed that patients with advanced dementia and a feeding tube frequently find themselves being rushed to the emergency room for treatment of tube-related complications.

By contrast, hand feeding has been found to be just as effective as tube feeding in terms of patient comfort. In fact, careful oral feeding may be one of few remaining pleasures for a person with advanced dementia.

“Mealtime must be regarded as an event of importance, instead of a task that needs to be completed as soon as possible,” explained the AGS.

Like all medical procedures, the benefits and burdens of a feeding tube should be fully discussed with the patient’s family before consent is given.

The U.S. Supreme Court has ruled that artificial feeding is a form of “medical therapy” that, like any other medical therapy, can be started and stopped based on the wishes and values of the patient or their health care surrogate.

Nursing homes should honor the preferences of patients (as indicated by advance directives) or family members when it comes to tube feeding. Nursing homes should not exert pressure on family members to institute tube feeding when hand feeding is the better alternative for their loved ones.

If you need an experienced Naples personal injury lawyer, contact The Hollander Law Firm today for a free consultation at 888.751.7777.