Ethical problems in feeding patients with advanced dementia

Area of Science:

• Gerontology
• Psychology
• Palliative Care

Background:

• Dementia patients often reach a terminal phase marked by feeding difficulties.
• Failure in spoon-feeding induces significant anxiety among healthcare workers.
• The patient-care worker interaction during feeding failure can be analyzed using psychological models.

Purpose of the Study:

• To describe the interaction between patients with dementia and care-workers during spoon-feeding failure.
• To identify the psychological dynamics, specifically double-binding, involved in this interaction.
• To highlight the negative consequences of this dynamic and suggest areas for intervention.

Main Methods:

• Qualitative analysis of the patient-care worker interaction during spoon-feeding failure.
• Application of the psychological model of double-binding to understand the dynamics.
• Observation and description of consequences such as distancing and scapegoating.

Main Results:

• The interaction during spoon-feeding failure is characterized by a double-binding dynamic.
• This double-binding leads to care-workers distancing themselves from patients.
• Scapegoating among care-workers is another significant consequence observed.

Conclusions:

• The double-binding dynamic in spoon-feeding failure negatively impacts care-worker-patient relationships.
• Reducing the pressure of double-bindings within wards is crucial.
• Interventions aimed at mitigating these psychological pressures are essential for improved care environments.