For example nursing home residents who have had strokes or some other extremely debilitating medical condition sometimes cannot swallow. The resident and family must then decide whether to use a feeding tube. The feeding tube provides nutrition and hydration and extends life for people who cannot take in their own nutrition and hydration by swallowing.

Feeding tubes, however, are not without difficulties. The most common type of feeding tube utilized long-term is the percutaneous endoscopic gastrostomy tube or PEG tube. The Peg tube is surgically inserted through the abdomen into the stomach. The surgeon uses a camera inserted through the mouth down into the stomach to perform the surgery. The feeding tube rests in the stomach and exits through the skin. The nurses must carefully clean the surgical site for the remainder of the resident’s life in order to avoid infection.

The tube, of course, interferes with a resident’s mobility. While it provides sufficient nutrition and hydration for the resident to stay alive, it also has side effects and does not do as good a job providing nutrition as normal chewing and swallowing. Side effects include bloating and diarrhea. People on PEG tubes are at risk for poor nutrition and digestive problems. Because of the potential for poor nutrition and decreased mobility, they are also a risk for bedsores. For more information about this feeding tube, see the entry in Wikipedia through this link. http://en.wikipedia.org/wiki/Feeding_tube.

Any decisions about health care in a nursing home or hospital require balancing the goal of extending life with the goal of living a quality life. We recommend that family members talk about end-of-life planning in a very frank and nonjudgmental way well before decisions must be made in a nursing home or hospital. The best way to do this is to consider a thorough living will and designation of health care surrogate as allowed by Florida law.