Older adults who experience difficulty chewing and swallowing, no longer have the ability to eat well, or are unintentionally losing weight may appear to be candidates for a medical intervention known as a feeding tube. Before using a feeding tube, consider the risks and ethical implications.
What is the purpose of a feeding tube?
A feeding tube delivers nutrients to a senior who is no longer able to consume healthy foods due to significant challenges with eating or drinking on their own. Upon inserting a flexible, hollow feeding tube through surgical means, liquid nutrition is delivered to the older adult.
How is a feeding tube inserted?
A feeding tube goes directly into the stomach. However, a surgical procedure is first required to place the feeding tube. A surgical cut is made into the left side of the senior’s cleaned and numbed abdomen. The feeding tube is inserted into this cut. Stitches close the surgical area.
The elderly patient’s stomach and abdomen generally heal within 5 to 7 days. If the senior experiences moderate pain, it can be treated with medications. Feedings start slowly with clear liquids and increase as time goes on. A surgically inserted feeding tube is intended to be permanent or long-term.
Alternately, a feeding tube may be placed non-surgically via the nose or mouth. The tube ends up in the stomach or the small intestine. A nasogastric tube goes through the nostrils and ends in the stomach. Or the tube can be inserted through the mouth and lead into the stomach.
When do families consider a feeding tube?
Seniors and their families may consider a feeding tube when the former can no longer eat normally. This may be due to certain head, neck, or esophageal cancers, for instance. Physicians may also recommend feeding tubes in cases of head trauma, traumatic brain injury, stroke, Parkinson’s disease, or dementia.
Dysphagia is a condition whereby a dementia patient loses the ability to chew and swallow safely. Serious health concerns, such as the risk of the senior inhaling food or drink, develop. Plus, dysphagia can lead to a lung infection called aspiration pneumonia, which can be fatal.
Seniors placed on ventilators may also be urged to consider a feeding tube. A ventilator helps patients breathe by first creating a surgical airway into the trachea. A trach tube is placed into this opening, preventing the aging adult from taking food or drink by mouth—necessitating a feeding tube.
When is it wrong to use a feeding tube?
Families have a difficult choice when faced with any of these scenarios and must begin discussions about feeding tube placement. The choice to use a feeding tube falls onto the senior’s guardian when the senior is not mentally capable or conscious of making this decision.
1. Surgical Risks
A percutaneous endoscopic gastrostomy (PEG) tube is usually recommended by healthcare providers. Inserting this feeding tube comes with complications and risks. As mentioned, a surgical procedure is required to insert a gastrostomy feeding tube—and bleeding and infection are associated risks.
2. Need for Chemical or Physical Restraints
Although healthcare professionals claim that a PEG tube prevents aspiration and the risk of pneumonia and increases nutritional intake, research shows that such benefits are not guaranteed. Aspiration can still occur. Plus, patients may need to be restrained to prevent them from pulling out the tubes.
3. Increased Risk of Aspiration Pneumonia
Aspiration pneumonia is most commonly caused by secretions from the mouth and sinuses and food regurgitated from the stomach. Tube feedings fail to protect the lungs. In fact, studies show that feeding tubes increase a senior’s risk of developing aspiration pneumonia.
4. Discomfort in Terminal Patients
A reduced appetite and disinterest in food and drink are expected near the end of life. The body gradually shuts down normal processes, including digestion, as it progresses toward death. Forcibly feeding terminal patients at this stage can cause them discomfort.
5. Unclear Benefits
Another consideration is that elderly individuals at the end stage of dementia may not live longer despite being fitted with a feeding tube. Attempting to figure out how a dementia patient feels about this aggressive medical intervention is also impossible.
Tube feeding fails to provide benefits that are important to the patient. Along with not extending life, the tubes do not relieve suffering. Delivering food and water through a tube increases stool and urine, making it difficult to keep them clean. Further, overmedication can interfere with feeding.
What is the alternative to a feeding tube?
Hand feeding is recommended as a gentler way of providing essential nutrients to seniors who cannot eat well. Pureed food is usually given after observing the senior’s nonverbal cues of hunger or thirst. If the senior shows no interest in the process, they are not forced to eat or drink.
Seniors often experience challenges with eating due to dental health issues, difficulty swallowing and chewing, or a lack of appetite. When your aging loved one loses interest in eating, the caregivers at Assisting Hands Home Care can provide reliable help to support their nutrition intake.
Professional caregivers from our home care agency are tasked with shopping for fresh groceries and preparing balanced meals. We provide compassionate assistance when seniors cannot eat independently. Plus, our pleasant companionship during mealtimes adds a valuable social component that encourages them to eat more food and maintain a healthy weight.
Additional in-home elder care services include discreet assistance with personal hygiene tasks, like bathing, dressing, and toileting. Seniors who are incontinent stay clean and comfortable with our help. Support with morning and nighttime routines is provided and we offer timely medication reminders.
Choosing whether to use a feeding tube is a difficult decision. But choosing Assisting Hands Home Care for quality senior home care is one of the easiest decisions that families in Batavia, Aurora, St Charles, Bartlett, Geneva, IL and the surrounding areas can make. Schedule a free in-home consult to learn more about the benefits of elder care at (630) 948-8193.
