Navigation Links
Families need to know more about feeding tubes for elderly dementia patients

PROVIDENCE, R.I. [Brown University] Despite evidence that feeding tubes do not improve survival rates or quality of life for elderly patients with advanced dementia, their frequency of use varies widely across the states. A new survey of family members finds that discussions surrounding the decision to place feeding tubes surgically are often inadequate.

Advanced dementia is a terminal illness that often affects a patient's ability to eat. In prior research, Joan Teno, professor of community health at Brown University, has documented a striking variation in feeding tube insertion rates.

To gain insight into the decision process and how it is informed by doctors, Teno and colleagues led a five-state survey regarding feeding tube insertion with family members of elderly patients who had advanced dementia. The results, published online in advance by the Journal of the American Geriatrics Society, will appear in the May 13 print issue.

"Our results suggest that in these states with a high rate of feeding tube insertion we need to improve decision making so that the decision to insert a feeding tube is based on a process that elicits and respects patient's wishes," said Teno, the paper's lead author.

Among the study's key findings:

  • 13.7 percent of family members who said their family member received a feeding tube stated that medical providers inserted the tube without discussing it first;
  • 11.2 percent said they felt pressured by the physician to put in a feeding tube;
  • 38.2 percent believed that that physician was strongly in favor of feeding tube insertion;
  • 41.6 percent of the time the discussion regarding feeding tube insertion lasted less than 15 minutes;
  • 39.3 percent did not discuss the risks of feeding tubes.

The study sample size was 486 people in five states, mostly sons and daughters who were either the persons named in an advance directive or were the person identified as the surrogate decision maker for a patient with advanced dementia. Teno led a group of researchers from Brown, the Hebrew Senior Life Institute for Aging Research in Massachusetts, and the University of Texas Southwestern Medical Center in asking people to describe the communication they had with physicians surrounding whether to insert a feeding tube for their loved ones.

The five states were selected because they had especially high (Texas, Alabama, and Florida) or very low (Massachusetts and Minnesota) rates of intubation. Extrapolating the survey group to the entire population of the five states, much like public opinion polls do, the figures would represent 9,652 cases of elderly patients with eating problems while dying from advanced dementia.

Some satisfaction

Despite research studies that question the value of feeding tubes, 32.9 percent of people in the survey said the feeding tube did improve quality of life for their loved ones. That was more than the 23.4 percent who said they regretted using a tube.

Teno cautioned against becoming complacent about the level of satisfaction family members recall, especially after dialogues that sometimes lack all elements necessary for fully informed consent.

"I watch people who make decisions that are really difficult," she said. "To continue on they have to make peace with their decisions."


Contact: David Orenstein
Brown University

Related medicine news :

1. Als Angels Love and Laughter Event to Support Children and Families in Desperate Need
2. March of Dimes National Ambassador Families and Senior Leadership Meet with President Obama
3. New Insurance Membership Program Protects Washington State Families Against High Cost of Emergency Medical Transports
4. Retirement Wont End Influence of Arkansas Physician on Families and Marriages
5. Leading U.S. Infertility Practice Opens Boston IVF The Maine Center in Portland, Helping Build Families in Maine
6. Families Fighting Flu Commends the CDCs Advisory Committee on Immunization Practices Recommendation for Universal Influenza Vaccination
7. Plotting and treachery in ant royal families
8. KID HEALTHY-Steps to Healthy Living Kicks Off 2010 Campaign to Make Southern California Kids and Families Healthier
9. Crossroads for Growth Drawing Attention This World Autism Day to Help NJ Families Obtain Autism Treatment
10. Recent Earthquakes Across the World Underscore the Importance of Emergency Preparedness Supplies and Survival Kits for Individuals, Families and Businesses
11. Novel medical home program for pediatric patients, families cuts ER visits in half
Post Your Comments:
(Date:6/26/2016)... ... , ... PawPaws brand pet supplements owned by Whole Health Supply ... health of felines. The formula is all-natural and is made from Chinese herbs that ... Cat Kidney Support Supplement Soft Chews are Astragalus Root Extract and Rehmannia Root ...
(Date:6/25/2016)... ... June 25, 2016 , ... Experts from the American ... Annual Research Meeting June 26-28, 2016, at the Hynes Convention Center in Boston. ... including advance care planning, healthcare costs and patient and family engagement. , AIR ...
(Date:6/25/2016)... ... June 25, 2016 , ... "With 30 hand-drawn hand gesture animations, ... Christina Austin - CEO of Pixel Film Studios. , ProHand Cartoon’s package transforms ... Final Cut Pro X . Simply select a ProHand generator and drag it above ...
(Date:6/25/2016)... ... 25, 2016 , ... Dr. Calvin Johnson has dedicated his ... implemented orthobiologic procedures as a method for treating his patients. The procedure is ... to perform the treatment. Orthobiologics are substances that orthopaedic surgeons use to help ...
(Date:6/24/2016)... , ... June 24, 2016 , ... A recent ... most people are unfamiliar with. The article goes on to state that individuals are ... many of these less common operations such as calf and cheek reduction. The Los ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)...  Arkis BioSciences, a leading innovator in the ... cerebrospinal fluid treatments, today announced it has secured ... led by Innova Memphis, followed by Angel Capital ... Arkis, new financing will accelerate the commercialization of ... of its in-licensed Endexo® technology. ...
(Date:6/23/2016)... 2016 Any dentist who has made an implant ... process. Many of them do not even offer this as ... high laboratory costs involved. And those who ARE able to ... a high cost that the majority of today,s patients would ... Parsa Zadeh , founder of Dental Evolutions Inc. and inventor ...
(Date:6/23/2016)... -- Roche (SIX: RO, ROG; OTCQX: RHHBY) announced that ... PCT (procalcitonin) assay as a dedicated testing solution for ... clearance, Roche is the first IVD company in the ... risk assessment and management. PCT is a ... in blood can aid clinicians in assessing the risk ...
Breaking Medicine Technology: