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My mother has pneumonia and dementia. She has been in the hospital for 8 days. The doctor just called me to say that she was not responding to the antibiotics and steroids and that she was not going home any time soon. He knows that I do not want to put her in a nursing home because I had a couple bad experiences earlier. I've put her in and taken her back home. He said that she was silently aspirating when drowsy and the meds make her drowsy and this was a vicious cycle. He said " you don't want her on a feeding tube right?" and I said yes. Should I try the feeding tube? Please give me a few suggestions.

I don't want to be put in a position where I have to make the decision to remove the tube and that's my reason not to try this in the first place.

Thank you.

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Onlychild, I'm sorry about your mom's illness. I know how hard it is to see a parent so ill.

If your mom isn't eating, and she has pneumonia, and the medications aren't working it might be time to begin the process of letting go. A feeding tube is considered an "extraordinary measure" in keeping someone alive like a Dr. shocking someone's heart back into rhythm or putting someone on a respirator so they can breathe. Personally, when I think of any of these things being done to my dad I get nauseous.

So I guess the question is how far would you like to go to keep your mom alive? If you feel very strongly about a feeding tube apparently that's an option. But if it were me and my dad I'd vehemently refuse it and let nature take its course. A feeding tube is very invasive and I know my dad would not want anyone trying to keep him alive like that.

It won't cure your mom of the pneumonia. I think it was just an option the Dr. was throwing out there because that's what Dr.'s are supposed to do. In not choosing the feeding tube you were choosing the more humane option for your mom, in my opinion.
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Agreed. Feeding tubes are not recommended for patients with dementia in part because they frequently pull them out, not understanding why they are there. This is such a tough time for you. Be kind to yourself.
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I can't speak about the advisability of a feeding tube for a person with dementia. As an RN, I don't recall ever having had such a patient.

As well, by the way your doctor phrased the question, he or she appears to be giving you a hint in regards to his own beliefs.

That said, here are a couple of things to think about with feeding tubes. First, they're easy to use. You probably won't have a problem feeding your mother with one.

But, second, they won't necessarily solve her problems with aspiration. Because patients are rapidly ingesting large amounts of liquid through feeding tubes, they often aspirate after feeding. The risk of aspiration can be decreased by having your mother sit up for 30-60 minutes after feeding. That will greatly reduce aspiration risk, but no entirely.
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My mom had dementia and was bedridden for years. She started choking a lot on the food. We went from solid to grinded to pureed. She kept choking. We had hospice service and they explained the process of her dementia (forgetting to swallow, etc...) Her hands had turned black and kept choking - even when not eating. So father took her to the ER, and they put a stomach tube. This prolonged mom's life for years. BUT, she became vegetative state, stared into space with blank eyes, never moved her head or hand or fingers, nothing. This is how she lived for over 5 years. You see, father didn't want her to die. He was willing to do whatever it takes to keep her living.

When mom was still moving, she tried to pull the tube out. We covered it with towel under her gown. And yes, even with the stomach tube, she was still choking. You see, she also forgot to swallow her saliva. Due to her constant choking, another trip to the ER. This time, father agreed for a tracheostomy (hole in her throat) in which the oxygen machine was attached to. Due to constantly choking on her saliva, and the phlegm being so thick, we had to constantly suction down the hole. Had to learn how far to suction it. Go down too deep, she starts choking, turning so purple red gasping for breathe.

Because of her constant choking, trying to cough out the phlegm, her stomach would heave from the coughing. Because of that pressure, her stomach tube also was moving up and down the hole. So, when we cleaned it daily, her skin would be raw from the up/down tube, that it would be bloody. Gross too, because sometimes it has thick phlegm coming out of the hole. In all the years of cleaning that area, I have never gotten used to it.

Think very carefully before getting a stomach tube. It's one thing if it's temporary. Another if it's permanent.
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I feel really bad for you and I understand. I lost my Mother over 24 years ago and it was a slow and painful process. Do not put your mother on a feeding tube. It only prolongs the inevitable. If she is that sick, now you do not want to make it longer for her, do you? (Dr's words and mine) My brother in law just had a feeding tube and like they said a person can aspirate on the tube just as easily as off the tube. If the body is shutting down, it cannot use the nutrition, and it just runs up the esophagus when the person is in a reclining position. And thus they aspirate! Let nature take its course. Your mother is going on to a better place and she is probably looking forward to it by now! My brother in law died after having had the feeding tube for four months. His cause of death, on the death certificate was : MALNUTRITION.
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Unless you can hire somebody to watch that tube 24/7 you should not experiment with it! Most horrible experiences with dementia patients pulling out feeding tubes and catheters!
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Years ago when people were failing their immune systems poor, they easily contracted pneumonia. It was a natural process of life to death. Now, all sorts of measures may be used to extend some people's very poor quality of life. I think when decisions like these have to be made, one has to weigh what is the quality of life the person has now and what will it be in the near future? Is there a chance of recovery? The doctor's wording jumped out at me also...."You don't want a feeding tube right?" It tells me it probably is not a good idea.
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wamnanealz , what do you mean about a recliner? My Mom signed a living will years ago,no feeding tube. She chokes unless I feed her 1teaspoon at a time of thickened fluids. Sometimes she starts to cough without eating,willstart to wheeze,and I need to give a nebulizer treatment. I would love ideas from anyone on this also please. I hired a new girl so I can train herand get out on weekends but moms chokes/coughs to a spit up with her,takes constant watching for swallows and patience.
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I have moved my mother into a private ALF home that is an "age in place" home. It is considerably less expensive than a nursing home. This home will be able to have up to 4 residents at all levels of care including hospice care when the time comes. The private homes in my area can have as many as 8 patients. At the home that my mother is in there is a caregiver 24/7 of course, they make her meals, make her laundry, activities, and all bathroom needs.
I would never put my mother into a nursing home because of the experience that we went through when my father lived in one for his last 7 year due to Parkinson disease. When he had the flu and was hospitalized they tried to put in a feeding tube but I convinced my mother not to authorize it! A feeding tube would mean no human contact unless they needed to change his diaper or his liquid nutrition. He was able to still eat and swallow even if he was being fed 3x a day. A whole year later when he did start to aspirate his food it did become necessary for him to have a feeding tube. He lasted 9 months more with the tube before Parkinson took his life.
Please look into private home based assisted living homes, maybe you will find one that will be just right for her!! A Place for Mom can help with giving you a list of homes in your area for you to go and look at. God Bless you as you make this difficult decision.
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My mother is in a home with 4 adults patients.
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