Tube feeding for older adults with advanced dementia offers no benefit over careful feeding assistance related to the outcomes of aspiration pneumonia and the extension of life. While food is the preferred form of obtaining nutrition, oral supplements may be beneficial if this intervention meets the person’s known goals of care. Tube feeding may contribute to client discomfort and result in agitation, the use of physical and/or chemical restraint and worsening pressure wounds.
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.
American Geriatrics Society Ethics Committee and Clinical Practice and Models of Care Committee. American Geriatrics Society feeding tubes in advanced dementia position statement. J Am Geriatr Soc. 2014 Aug;62(8):1590-3. PMID: 25039796.
Choosing Wisely Canada. Canadian Geriatrics Society: Five things physicians and patients should question [Internet]. 2017 Jun [cited 2016 Oct 21].
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. Tube feeding versus assisted oral feeding for persons with dementia: using evidence to support decision-making. Ann Longterm Care. 2013 Jan;21(1):36-39.
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