Whether to Use a Feeding Tube in Dementia Patients

Last year I wrote a blog arguing for better-informed decisions about the use of feeding tubes in dementia patients. A survey conducted across 5 US states shows that the relatives or health proxies are often ill-informed before being asked to decide on the use of feeding tubes.  It’s reported in the Journal of the American Geriatrics Society.

The five states selected were: Texas, Alabama, Florida (all three with very high rates of intubation), and Massachusetts and Minnesota (states with very low rates).  Survey results were received from 486 people whose relative had died from dementia; they were mostly sons and daughters who were either the persons named in an advanced directive or were the one identified as the surrogate decision maker for a patient with advance dementia.  Only 11% of the patients had a feeding tube; the following are some of the key findings from these patients’ surrogates:   

33% of them said the feeding tube improved the patient’s quality-of-life

23% said they regretted using a tube

14% said there was no prior discussion about inserting the tube

42% reported a discussion that was shorter than 15 minutes

39% said there was no mention of the risks of feeding tubes

52% said they believed the heathcare provider was strongly in favor of using a tube

11% said they felt pressured by the physician to put in a feeding tube

26% of the patients were physically restrained

These results show that there’s lots of room for better education of relatives and health proxies of demented patients.  This is a duty to be shared by the physicians and nurses.  The available studies indicate strongly that there are hardly any benefits to the use of feeding tubes for demented patients.