Careful hand-feeding for patients with severe dementia is at least as good as tube-feeding for the outcomes of death, aspiration pneumonia, functional status and patient comfort. Food is the preferred nutrient. Use of oral nutritional supplements may be beneficial. Tube-feeding is associated with agitation, increased use of physical and chemical restraints and worsening pressure ulcers.
Sources:
Allen VJ, et al. Use of nutritional complete supplements in older adults with dementia: Systematic review and meta-analysis of clinical outcomes. Clin Nutr. 2013 Dec;32(6):950-7. PMID: 23591150.
Finucane TE, et al. Tube feeding in patients with advanced dementia: A review of the evidence. JAMA. 1999 Oct 13;282(14):1365-70. PMID: 10527184.
Gabriel SE, et al. Getting the methods right–the foundation of patient-centered outcomes research. N Engl J Med. 2012 Aug 30;367(9):787-90. PMID: 22830434.
Hanson LC, et al. Improving decision-making for feeding options in advanced dementia: A randomized, controlled trial. J Am Geriatr Soc. 2011 Nov;59(11):2009-16. PMID: 22091750.
Palecek EJ, et al. Comfort feeding only: A proposal to bring clarity to decision-making regarding difficulty with eating for persons with advanced dementia. J Am Geriatr Soc. 2010 Mar;58(3):580-4. PMID: 20398123.
Teno JM, et al. Decision-making and outcomes of feeding tube insertion: A five-state study. J Am Geriatr Soc. 2011 May;59(5):881-6. PMID: 21539524.
Related Resources:
Patient Pamphlet: Feeding Tubes for People with Alzheimer’s Disease: When you need them and when you don’t