Tube feeding in dementia: a controversial practice

Primary care providers for patients with endstage dementia are often confronted with difficult tube feeding decisions. Decreased food intake occurs with increasing age which can be worsened by dementia. Often the solution is to provide food by way of tube feeding. However, no improvement in survival has been found with the use of tube feeding in anorexia caused by endstage dementia. Several complications involving pulmonary, gastrointestinal and renal systems are common. Ethical and legal considerations weigh tube feeding as basic care versus a medical treatment. Nursing home and state regulations designed to prevent abuse challenge patient's rights to refuse tube feeding as a medical treatment. This review discusses the complications and issues surrounding the use of this practice in end stage dementia.