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Tube feeding preferences among nursing home residents
L A O'Brien1, E A Siegert, J A Grisso
1Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, USA.
Objective:
To determine the preferences of nursing home residents regarding the use of tube feedings and to characterize the clinical, functional, and psychosocial factors that are associated with preferences.
Design:
In-person survey.
Setting:
Forty-nine randomly selected nursing homes.
Patients/Participants:
Three hundred seventy-nine randomly selected, decisionally capable, nursing home residents.
Main Results:
Thirty-three percent of participants would prefer tube feedings if no longer able to eat because of permanent brain damage. Factors positively associated with preferences for tube feedings include male gender. African-American race, never having discussed treatment preferences with family members or health care providers, never having signed an advance directive, and believing that tube feeding preferences will be respected by the nursing home staff. Twenty-five percent of the participants changed from preferring tube feedings to not preferring tube feedings on learning that physical restraints are sometimes applied during the tube feeding process.
Conclusions:
Demographic and social factors are associated with preferences for tube feedings. The provision of information about the potential use of physical restraint altered a proportion of nursing home residents' treatment preferences.
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