View unanswered posts | View active topics It is currently Fri Apr 18, 2014 6:20 pm



Reply to topic  [ 9 posts ] 
 Feeding tube for dementia patients in nursing homes 
Author Message

Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post Feeding tube for dementia patients in nursing homes
This article about feeding tube use with dementia patients in nursing homes was interesting to me. 'For profit' places have an interest in keeping the patient alive as long as possible.

http://www.scnursinghomelaw.com/2010/03 ... ing-tubes/

_________________
Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Tue Mar 15, 2011 8:29 pm
Profile

Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: Feeding tube for dementia patients in nursing homes
I have found many articles discussing this study, but I have not been able to find the list of hospitals and their use rate. If any one comes across it, please share!

I thought this discussion of the study was pretty interesting: http://www.aan.com/elibrary/neurologytoday/?event=home.showArticle&id=ovid.com:/bib/ovftdb/00132985-201003180-00012#P30

_________________
Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Tue Mar 15, 2011 9:42 pm
Profile

Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3173
Location: WA
Post Re: Feeding tube for dementia patients in nursing homes
I like this quote:
As an alternative to feeding-tube placement, Dr. Karlawish said, “My counsel to the family is that if you can, get in there and get by the bedside with a tray of food and a spoon, and give it your best shot to feed them. I myself would enjoy having someone sitting there patiently feeding me, as opposed to having someone rush in and hanging another bottle of enteral feeding solution.”

Absolutely! There is no pleasure or comfort to be had from a tube feeding. None.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Tue Mar 15, 2011 10:02 pm
Profile

Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Feeding tube for dementia patients in nursing homes
Two "comforts" I can think of with tube feeding are that it stops the choking associated with eating/drinking and ends tiring 2-hour meals.


Tue Mar 15, 2011 11:11 pm
Profile

Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: Feeding tube for dementia patients in nursing homes
But it doesn't stop aspirational pneumonia. Does it really stop choking? Can't a person unable to swallow choke on his own saliva? I don't know. That is not an argumentative question -- just a request for information.

To me the real shocker in this study was how often the feeding tube was inserted without considering what the patient would want and even against the patient's own written directive.

If the person or the family speaking for the person has religious views that dictate or direct the use of feeding tubes, fine, respect that. If the family feels the patient would be more comfortable with a feeding tube than with prolonged manual feedings, respect that. But for hospitals (or nursing homes, but apparently this generally starts in a hospital) to insert them for their own convenience is very scary to me. This description by one of the doctors in the article I referred to is what I mean: "“There's a keen focus on length of stay and getting the patient back quickly to where he or she came from. In the case of a frail older adult with advanced dementia, coming from a nursing home with trouble swallowing, there would be pressure to say, ‘We have to get her eating, we'll put a feeding tube in so she can leave.’"

I would not be judgmental of a caregiver who makes the decision either to use or to not use a feeding tube. It is a personal decision, made in love.

_________________
Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Wed Mar 16, 2011 12:12 am
Profile

Joined: Sat Jul 31, 2010 5:28 pm
Posts: 317
Post Re: Feeding tube for dementia patients in nursing homes
It does not stop aspiration of saliva. So, there are patches put behind the ear and medications given to dry up the secretions that normally keep your mouth and nasal passages moist. After the insertion you get all your nutriton through a tube, never getting to taste things again and you live with cotton mouth all day, every day. The wife of a friend died 5 years ago after two years in a nursing home because a feeding tube was inserted or they told her she would die. The family let her make the decision and she opted for a tube. It was a tough two years from tube to death. That's when Del said, "I don't ever want a feeding tube." And I agreed that I would never let them do that to him. Nan


Wed Mar 16, 2011 12:19 am
Profile

Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3173
Location: WA
Post Re: Feeding tube for dementia patients in nursing homes
Quote:
I would not be judgmental of a caregiver who makes the decision either to use or to not use a feeding tube. It is a personal decision, made in love.

Neither would I, Jeanne.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Mar 16, 2011 12:23 am
Profile

Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3113
Location: Vermont
Post Re: Feeding tube for dementia patients in nursing homes
Nor I, in the situation my dad was in. He wouldn't have wanted his torture prolonged any more than the rest of us would want to see his torturous life prolonged. He had a horrible 18 mo. of decline, and that was more than enough for anyone to have to go through. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Wed Mar 16, 2011 9:30 pm
Profile

Joined: Sat Jan 03, 2009 2:59 pm
Posts: 1978
Post Re: Feeding tube for dementia patients in nursing homes
This is indeed a personal decision !

_________________
Irene Selak


Fri Mar 18, 2011 10:41 am
Profile WWW
Display posts from previous:  Sort by  
Reply to topic   [ 9 posts ] 

You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Powered by phpBB © 2000, 2002, 2005, 2007 phpBB Group.
Designed by STSoftware for PTF.
Localized by Maël Soucaze © 2010 phpBB.fr