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Feeding tubes in patients with severe dementia
1Family Medicine Department, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. kostali@mindspring.com
American Family Physician
|May 7, 2002
Summary
Feeding tubes are often ineffective for advanced dementia patients and can cause harm. Hand feeding, while not always preventing malnutrition, prioritizes patient comfort and care.
Area of Science:
- Gerontology
- Palliative Care
- Clinical Nutrition
Background:
- Patients with advanced dementia present significant care challenges, particularly regarding nutrition and daily living activities.
- Difficulty with eating is a common and distressing issue for patients, families, and healthcare professionals.
Purpose of the Study:
- To evaluate the efficacy and adverse effects of feeding tubes in patients with advanced dementia.
- To explore alternatives to tube feeding for nutritional support in this population.
Main Methods:
- Review of existing studies on feeding tube use in advanced dementia.
- Comparison of outcomes between tube feeding and hand feeding.
Main Results:
- Feeding tubes have not proven effective in preventing malnutrition, pressure sores, aspiration pneumonia, or improving functional status or longevity.
- Feeding tubes are associated with high complication rates, increased restraint use, and other adverse effects.
- Hand feeding, while not guaranteeing prevention of malnutrition or dehydration, supports patient comfort and intimate care.
Conclusions:
- Feeding tubes should be reconsidered and avoided in many clinical scenarios for advanced dementia patients.
- Hand feeding is presented as a preferable alternative, emphasizing patient comfort and personalized care over artificial nutritional support.