Do you want them to cut you open and put in a feeding tube? July 6, 2009

If you are young, you are probably not thinking about feeding tubes.  If you are middle aged, you may be thinking about feeding tubes in relation to elderly parents but not yourself.  If you are elderly, time is running out to think about feeding tubes.

Of course no one likes to think about feeding tubes.  And, no one thinks they will need a feeding tube.  However, if you are in an accident and are seriously injured you may become so debilitated that you cannot swallow.  If you are elderly and suffer from dementia you may become so seriously debilitated that you cannot swallow.  That’s when the doctors ask you or your family to make a decision.

The issue then is how you want to balance extending life with quality of life.  That’s a decision you should make after careful thought, after talking to your family and after becoming fully informed.

One common form of feeding tube used for long-term care is the PEG tube. PEG stands for percutaneous endoscopic gastrostomy tube. The surgeon cuts a hole in your abdomen and inserts the tube directly into your stomach.

A study published in April, 2009 indicates that there is little evidence feeding tubes benefit patients with advanced dementia. The study author says that tube feedings in the elderly with dementia may not even prolong life and that physical restraints were used for 71% of the patients studied.

In our nursing home neglect practice in Daytona Beach we often see elderly patients restrained because they forcibly take out their feeding tubes. This usually happens because the patient is too confused to understand what the feeding tube is.

The use of feeding tubes can be extremely controversial without clear direction from the patient.  You may remember the case of the unfortunate Florida woman who had been on a feeding tube for a long time.  Her husband directed the doctors to remove the feeding tube but politicians and the media intervened creating what could only be described as a media circus that was emotionally wrenching for everybody involved.

Therefore, we recommend that you sign a living will making it clear whether you want a feeding tube.  We will have more on feeding tubes and living wills in a later posting.