What are the pros and cons of using a feeding tube?

This is a very emotionally driven decision in many cases. Is there a living will? What is the goal of artifical feeds? Longterm for someone with dementia differs from someone recovering from an acute illness with quality of life. Generally speaking though, if we are talking about someone with Advanced Dementia...it is part of the end staqe process. Most patients become a "failure to thrieve" with muscle wasting and cachexia. It is not starvation in the truist sense, but part of the end stage disease process. I would be very reluctant to place one, because it is much more difficult to make a decision to remove or stop feeds, but trust the natural process. As a former hospice nurse, I have witnessed the medical community make families feel guilty for giving up or withholding, however if you asked most if it was them, they would not! ? Go figure???? Anyway, the risks of placement #1...Aspiration pneumonia; as they are not able to swallow appropriately and not uncommon for reflux to occur. #2 skin breakdown as part of fluid overload if there is kidney insufficiency which could lead to edema, open wounds, and pain. These are all issues that should be weighed carefully before making a decision, but bottomline....if there is Advance Directives (living Will) stating no artificial nutrition or hydration you have your answer! If you don't have a Living Will, everyone consider. Pamela

At the end of life dying body performs in exactly the someway with or without a feeding tube. Someone who is unable to swallow from disease or injury will be able to prolong their life significantly but in the end with or without a tube the body will reject food as systems shut down. With a gastric tube there will be food remaining in the stomach between feedings and the patient will vomit and with a J tube a lot of food will remain between feedings and the patient will become bloated and uncomfortable, When other signs of imminent death are present it is pointless to place a tube for a few short weeks or days because the patient is refusing food.
certain diseases may twist the body and then a tube can prolong life for a significant length of time as in the case of Stephen Hawkin who probably has a tube although no one has said so. One young beauty recently posed in a bikini with her tube in full view. She will probably have many years ahead of her. (Don't worry folks I am not going out to buy a bikini) but I certainly would be prepared to swim in a nice warm pool. Anyone with specific questions is welcome to post on my board and i will answer them truthfully.

My experience with inserting a feeding tube in my Dad's stomach has been horrific.
He had bed sores, (which the nursing home failed to, or chose NOT to, inform us) which my Dad already had infection running through his body. He died two days later after the feeding tube was inserted.
If I had it to do over again, I would not do it at all. It brought on much more unneccesary pain to his final days.
Which brings up another point, I really get aggravated at how people have an automatic response of "placing an elder in a facility"...It is not such an easy task. ALL facilities MUST be investigated, personal visits, interviews with current resident's and or their famillies. This website is to assist, advise, support CAREGIVERS who are caring for their elder at home.

Pro-they may live longer
Con-they may die more slowly
If their brain is dying because of Alzheimer's I don't know if it makes sense to prolong the dying process. If their brain is working well and they have a measure of satisfaction from life, go for it.
I think often feeding tubes are used to feed the emotional needs of the family as much as the physical needs of the patient.

While I hate having a feeding tube it really does not restrict me in any way. I set up the feedings overnight while I am asleep and during the day can eat anything I fancy as long as I can get it down in small quantities. I do have to use the commercial feeds, but Medicare pays, because i have a J tube which is fairly small in diameter. The gastric tubes are bigger so it is possible to use home made foods with little risk of blocking the tube.

My initial thought is not to insert a feeding tube unless it's a temporary thing, while healing is going on or some kind of recuperation, but then I read tommullen's post, and I may alter my opinion. I guess if it seems as if the person would like to eat, but just can't swallow anymore, it might be worth doing. But if a person is showing no interest in eating, I'm inclined to say don't do it. They did put one in my grandma (I was not part of the decision makers for her), and I think her daughters would make a different decision today. Maybe. Who knows? You do the best you can in the moment with the information you have. I don't think I would put one in my mom, who now has dementia. In fact, i am pretty sure I would not, as I seek to avoid the hospital at nearly all costs.

My mother has been in nursing home care for 11 years and declining health since the 1970's. She has a serious mental health problem that led to her declining physical health. I have chose NOT to place a feeding tube due to the aspiration pneumonia she severely had just two years ago with her failure to thrive condition. I've seen her suffer since I was a child. I'm 53...she's 73..and she is wasting away. My tears are heavy right now and Hospice is starting to look in on her again for the second time. God is preparing a new home for her now, So....No artificial anything!

GENERAL rule of thumb - feeding tube for most people with advanced dementia does not improve either quality or quantity of life, but for most people with a specific reason for swallowing trouble - Stephen Hawking being a good example - it can do both, for many, many years. Feeding tubes do not limit speech, mobility, or other activities for someone who knows not to pull them out. Placing a surgical tube is usually better than having it through the nose chronically and sometimes it is a really simple procedure. You can typically still eat by mouth if you are otherwise able and safe to do so. This is a really good post because it should be an individualized decision based on each person's diagnosis and prognosis, and realistic goals; eliminating myths and worries about feeding tubes, as well as avoiding the cookie-cutter approach that says either everybody or nobody should get one is really important.

UrPatientAdvo , All of us, All of us, need to face this issue. Thank you for commenting. When we drew up our trust I talked to my oldest daughter regarding my wishes if I have no chance of recovering. She said she couldn't pull the plug. So, I made my youngest daughter executer of my health if my husband wasn't available. I do not want feeding tubes or anything else to prolong my death.

My brother had a feeding tube while he was recovering from throat cancer, in his fifties. That lasted several months. It is out now, he is eating normally, and we all are delighted. I am certainly glad this technology is available. I would chose it for myself if I had a temporary need for it and a good chance of recovering (although the older I get the less likely I am to make that choice.)

For an elderly person with dementia, I don't think it is a good choice. We turned it down for my husband twice while he had dementia. From what I have read, it does not change the outcome and it usually involves some kind of restraint. A person with dementia, even if they understand and agree to the device, is just going to have a real hard time leaving it alone.

And there are unusual cases (as vstefans points out) where the feeding tube is needed long term, and allows the person to function normally in other respects.

There is no one-size-fits-all answer to the question "Should my loved one have a feeding tube?"