Follow
Share

My mum had a severe stroke 3 months ago and is still in hospital . She cannot swallow and is being fed through a nasal tube.
Doctors want to move the tube to the stomach so she can be moved from hospital into a home. She mostly sleeps and seems very weak, but sometimes she says the odd word. We have concerns with them moving the tube, as she has been on antibiotics constantly for infections ..... and only had the odd day without. Currently she has low potassium ...and has a potassium bag. We feel she is too weak for the feed to be moved but the hospital cannot shift her out while she has a nasal tube. We are going in for a meeting on Friday with all doctors ...Any suggestions ...should we let them move the feed?

This question has been closed for answers. Ask a New Question.
Hi NYDIL: no she has not, I am wondering as well. I didn't know the patient was 90 y/o. Hope whatever their decision was they are comfortable with it.
Helpful Answer (0)
Report

The woman is 90 years old and had a stroke over 3 months ago and is still in the hospital. Has the poster come back to update us on her mother's quality of life or prognosis?
Helpful Answer (1)
Report

RE you feel she is too weak for the tube to be put in...

Putting in a peg is one of the simplest "surgeries." I watched them take my dad's out and realized it's just a small incision in the abdomen, then into the stomach. As long as you take basic steps to prevent infection after the incision, there's no huge recovery for this procedure. It's slightly more complicated than putting an IV in. Please don't worry too much about it, and focus on anything that gives your mom back some quality of life. I'm sure she'd like to get out of the hospital...? Good luck to you and your mom.
Helpful Answer (1)
Report

Hm. I think the "let her go" comments are somewhat misplaced here. The question is about moving from a nasogastric tube to peg tube for feeding. Peg tubes aren't that big of a deal, and many people have them either temporarily or long term.

So, yes, Krissy, I would say allow the doctors to move to a peg type tube. There will be home nurses for follow up care and you can learn how to flush the tube. My dad had one. It wasn't that difficult to deal with. I actually liked that I knew - by utilizing the peg - that he was getting nutrition regularly since he was severely underweight at the time.

There's nothing particularly scary about a peg tube. They're more common for long term feeding than the nasal kind.
Helpful Answer (1)
Report

arianne, intubated refers to being on a ventilator - it's not the same as a feeding tube! And if someone is getting something out of life it might be wrong to just end it because they can't swallow.
Helpful Answer (1)
Report

I agree with all who say in essence, "Let her go." My late husband's living will stated that he did not want to be intubated even if it was indicated. I honored his wishes. He was 84 years old and in poor health. I am 85 years old and in relatively good health, but I hope that if the time comes when I doctor wants to intubate me and I am unable to speak, my children will refuse.
Helpful Answer (2)
Report

PEG is usually a lot more comfortable convenient, with less promotion of reflux, than an NGT. It is probably worth the risk, which is not zero, because there really are more risks with a chronic NGT.
Helpful Answer (1)
Report

Deeshusband: Yes, that's why I suggested palliative care, e.g. your "get a grip" comment goes along with that mindset.
Helpful Answer (1)
Report

There are some very good suggestions here. We don't know her prognosis; is she expected to improve? Is she able to get out of bed? Her age?
The PEG insertion procedure is relatively simple. While it does require skilled nursing in the beginning, the nurses teach the family how to feed her themselves and do it safely. If your mom had AD follow her wishes. If she doesn't get your family together (include your mom if she is able) and discuss quality vs quantity of life for her future. "Massive" stroke doesn't sound very positive nor hopeful. Palliative care may be your option. As others mentioned, if she is immobile she can develop bedsores, one among a multitude of conditions that will only make her weaker. It's a rough decision. My mom too had a stroke and at 89 y/o I chose Hospice for her, and never regretted my decision. She passed comfortably and with dignity, and I had the honor of being with her when she passed. Good luck.
Helpful Answer (4)
Report

My mom fell and broke her hip then she started aspirating on her food so the put her feeding tube in her stomach. You just have to make sure she is digesting it or if she is full it can back up.
Helpful Answer (1)
Report

If you want to look at quantity of life rather than quality of life then she needs the PEG. The nasal tube cannot drip in enough flied which requires more time hooked up to it. The nasal tube moves around including risk of being out of position. This leaves risk of aspiration pneumonia which is chemical in nature rather than bacterial. And antibiotics will not be beneficial. Any pneumonia increases risk of death. Accepting a PEG at the time that you are being asked allows time for the wound to heal plus she can be assessed in the changes to boost her nutrition.
Helpful Answer (3)
Report

My father had a stroke 8 years ago and so I understand your concerns. He was also in the hospital for many months. I am not sure why everyone here is suggesting you make her comfortable until she dies as I didn't see anywhere in your original post that suggests she is not expected to make any recovery. Every change we made, worried us greatly (intubation to a trach, nasal feeding to peg tube, etc.). Anytime we added another piece of equipment, we were concerned as the most detrimental part of my dad's illness was caused by the infection he got in the hospital through his catheter and not by the stroke. We began to learn the signs for when something was wrong, blood pressure changes, more sleepy than usual, cloudy urine, etc. It is definitely a worry, but if there is a chance for recovery, you want to get her out of the hospital as quickly as possible and on to therapy. The earlier they start therapy, the better. We eventually got my dad off the peg tube, but it was helpful in the beginning as we could put his medications through it when he was too sleepy to take them or just wouldn't cooperate. Same when he wasn't drinking enough liquid, we could give him some additional nutrition and liquid. Eventually, he was able to eat well enough that we had the tube removed. Our feeling was always, the less stuff attached to him, the better. He would feel more like himself without it and there were fewer places where he could get an infection, but it served it's purpose while we had it. I wish you the best of luck. It can be a very difficult road. The biggest thing we learned was how critical it is to find the right doctors.
Helpful Answer (3)
Report

It may seem counterintuitive, but long term I would have thought that PEG feeding - where the tube goes directly into the stomach - would be much more comfortable for your mother. And although it needs skilled nursing management, it would also be less risky in terms of aspiration (where food or fluid can get accidentally misdirected down the windpipe instead of the gullet) and therefore infection.

If her doctors are recommending this for your mother you would have to have very sound reasons for rejecting their advice. Ask them to explain in more detail anything you're still concerned about, such as whether your mother is able to cope with the (comparatively minor) procedure; but I doubt if they would have proposed it if they didn't believe it was the best option available for your mother's overall comfort and wellbeing.

Looking at the date of your post I realise I'm too late: what was the outcome of your meeting?
Helpful Answer (0)
Report

You have to get a grip on the inevitable. Don't allow her to suffer any longer. Have a doctor put fluids in her and let her pass away in peace without pain. We all face the same destiny so make it a comfortable as possible for HER, and quick thinking of yourself and how you feel. Peace!
Helpful Answer (4)
Report

The kindest and most loving decisions are the most difficult. Look into home hospice and talk to the charge nurse about your mom's prognosis. Too many doctors have a treatment approach that prolongs quantity of life while reducing its quality. If the prognosis is bad, prolonging her life will deprive her of a good death.

Having recently lost my beloved mother-in-law, who had a living will and DNR, I can tell you that she made her wishes clear. My MIL had a good death - a death with dignity - and for that I am grateful. You have my sympathy.
Helpful Answer (5)
Report

Do her doctors think there may be an improvement? So much depends on that. If no improvement was predicted I would go with your mother's final directives if she has written them. Are you her medical proxy? My thoughts are with you as you go through these decisions. One big thing to consider is if you are just keeping her body alive if there is no hope of improvement. Does she do other things? Please let us know more. You know much better than we do. Is she able to tell you what she wants to do?
Helpful Answer (3)
Report

PEG can be good for some, bad for others.
Helpful Answer (0)
Report

I was the MPOA for my late mother and had placed a DNR order as per my late Mother's wishes.
Helpful Answer (2)
Report

This is a very difficult decision at best, since mom may decease. Have they suggested palliative care? My late mother suffered an ishemic stroke and was on pallative care until she deceased.
Helpful Answer (3)
Report

Did your mother ever fill out Advanced Directives? It would be a paper that says tubes yes or no, respirators yes or no, antibiotics yes or no etc. Find that. Go over that. Know what her wishes are, if she wants Hospice and when. PEG tubes add nothing to life expectancy. If her limbs are starting to stiffen up she has pain-- how do you want to treat that? How long before bedsores set in? How many times more can she have antibiotics before C-Diff /Thrush sets in? If the doctors recommend going home with Hospice, can you be there 24/7?
Helpful Answer (6)
Report

This question has been closed for answers. Ask a New Question.
Subscribe to
Our Newsletter