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I would not do that to a dementia patient. It's different if they still have their mind and want the procedure. Thank God my sister told me what she wanted, and we didn't do the stomach tube thing. Of course, I was harassed by one of her daughters (who wanted nothing to do with her when I needed help, before she slid into dementia). I was forced to become my sister's caregiver, but I am grateful she told me what she wanted, before she couldn't.
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loretta112j: To place a peg tube into an elder who suffers from dementia would be deemed rather cruel.
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IMO, absolutely not. Especially if she has any type of dementia…
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I'm so sorry you're at this stage. My Dad, who was a kind and wonderful person with no alzheimers passed 1 month shy of his 90th birthday due to this issue. Every bit of water or food that went in his mouth asperated his lungs. He didn't want the nasal tube, but we talked him into it. It was painful and part of me feels bad about that. They can only leave that in for a certain length of time before it must be removed (10 days?). During that time I constantly had to swab his dry mouth and suction the spit out because he couldn't swallow. When they took the tube out he refused the peg. My daughter is a nurse and talked to me about the failure rate and the pain that could result if we talked him in to getting the peg. We moved him to a beautiful hospice. His family was wirh him and he was never alone but it was agonizing for me. It can take up to a week for them to pass.
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No.
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No
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I wouldn't if the decision is yours, and assuming Mom cannot make her own decision.
I have already refused in my advanced directive (I am 80) dialysis, placement of NG or PEG or IV for nutritional delivery. So that would make the decision easy, but I was a nurse, and I surely do know after many long years of lessons what I don't want in terms of torment for myself at the end of life.
We all die. The question is, does Mom accept that? Do you? Is it time for end of life care and Hospice? I am sorry, but it sounds as tho the decision if yours. I know the anticipatory grief, but I doubt very much that placement of feeding tube will do anything but prolong pain, both mental and physical.
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Speaking as a potential patient …

i have paperwork with my pcp for no feeding tubes or ventilators etc when i reach the stage when i could not survive without them.

it’s scary … the thought of dying and no longer surviving … but that exactly what i think surviving is what it would be … just living day to day still waiting to die.

the thing that makes it easier for me is the thought of starting something and then having my family having to stop it.

has your mother ever expressed her wishes ? If not, as hard as it is, ask her if shes able yo talk to you about it.
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My mother had this procedure done following a stroke. Our family approved it after her doctors encouraged us with a great hope of recovery. Sadly, the recovery never came. In the circumstances of dementia, I’m pretty certain, as there is no chance of recovery, I would choose not to place the feeding tube. Once it’s placed, there becomes no good or simple way to decide to stop nutrition. No one becomes willing to “pull the plug” so to speak, it’s an impossible situation to be in
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A feeding tube to help get through a temporary illness might be reasonable, but if your mother is on a general decline and has reached he point of being unable to eat, a feeding tube would only be an invasive intrusion into the dying process and might actually cause her unnecessary discomfort in the dying process.
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Is she still capable of making good decisions for herself? What are her wishes? If the answer is "no" to the first question, does she have a Living Will? What are her instructions there? If she doesn't have a living will with her advance medical directives, do you think you know what she would want? Is she the kind of person who would want every step to be taken to prolong her life? Or would she rather let nature take its course and be in hosptice-type care, where she is made comfortable, and doesn't want extreme measures to fix things that are wrong with her. All operations with anesthesia take their toll with senior citizens. And does she want to be fed through a peg tube the rest of her life? All the best to you both!
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I was a party to the development of my recently deceased LO’s end of life choices and decisions.

She was an active Church goer, and everything in her decision making was shepherded by her lawyer and her long known clergy.

She firmly rejected this sort of sort of procedure, and I as her POA checked her final directives and additional documents as her illness progressed.

Until about 10 days before she died, she relished juices and nutritive beverages served with a straw. She progressively lost weight for the last 5 or 6 months of her life in spite of heroic efforts to encourage her to eat, and was finally described as having geriatric failure to thrive.

With your mother’s constellation of issues, it would seem potentially questionable at very least to subject her to any strenuous procedure(s) that would prolong life in any way.

My LO was enrolled in an on-site hospice program for about 18 months before her death, and both they and I agreed that she was peaceful and comfortable in spite of severe physical deterioration in her last 4 or 5 months.

We also agreed that no medications were needed as she came nearer to death.

If you have access to someone whom you trust to talk to, you might find comfort in a 2nd opinion. I took great consolation from conversations I had with some of my LO’s favorite clergy members.

Hoping you are able to access the help you need.
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Per your profile:

I am caring for my mother Clementine, who is 88 years old, living in my home with age-related decline, alzheimer's / dementia, diabetes, and urinary tract infection.

Under NO circumstances would I have EVER chosen to extend my mother's life after she was diagnosed with dementia! Her quality of life was dreadful with dementia, and extending it would have been an act of cruelty in my opinion. To place a PEG feeding tube into the stomach of a demented 88 year old woman to extend her life in such a state would serve what purpose, exactly?? Ask yourself that question, and when you come up with the answer, then you'll have the answer to the question you posted.

As dementia, a terminal condition, advances, the elder can become unable to swallow, unable to speak, unable to understand language, unable to walk, get out of bed, go the bathroom on their own, etc., all ending up with death, ultimately, which can be a terribly ugly thing to witness.

Put your mother's best interest at the forefront of the matter, and you'll have your answer. And ask yourself if YOU would want your life extended if you were suffering from dementia, diabetes, UTI and age related decline.

Best of luck with your decision.
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This is mom's call. If she cannot understand how it works or how it's going to affect her life from now on, I would be hesitant to have it done.

88 is a good long life. The peg tube will allow her to be nourished, and will prolong her life. But it comes, as so many of these 'procedures' at a cost. Quality of life being the first and foremost.

Assuming you have DPOA? If you don't, you can't do a thing to help her with this, other than be a sounding board for her questions.

What is her mental status like? Does she have a good attitude and a true desire to live longer? Or is she terrified of the march of time and the ultimate death that awaits us all?
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Isthisrealyreal Jan 2023
Legal next of kin can give directive for care, even without MCPOA.

It is just easier with it, in the event someone in the family wants to raise a stink.
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The procedure is not the question here at this point.
The anesthesia is exceptionally light for this procedure.
My concern is the choice to place a peg tube.
Only you understand your Mom's wishes for her end of life care. I personally, at 80, have for decades had specific PROHIBITION written into my advance directive that disallows such forced feedings. I have refused placement of NG (naso gastric) or PEG tubes for feeding, and have forbidden IV TPN (total parenteral nutrition). I have prohibited other things such as dialysis.
If your Mother gave you indications that she wishes to live under ANY conditions, and with ANY and ALL heroic measures, then you are following the instructions she gave you.
I am assuming you are medical POA.
If your mother has expressed to you in the past that she would not like to continue to be forced to live in these circumstances, that she feels that we all die and that she is at peace and content with her life, would like to pass in peace and contentment, you may wish to explore hospice, and allow your Mom to pass as peacefully as she is able.
As a nurse I can tell you that the placement of this tube, and the forced feeding of these nutritional substitutes for real food often mean diarrhea, bedsores, infection, and etc. They may prolong the quantity of life, but seldom help with any quality of life.
Only you can make these decisions now for your Mom, after speaking with an honest and forthright doctor.
I can only wish you the very best.
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Cover999 Jan 2023
Yes one that isn't in it for the money.
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https://www.choosingwisely.org/patient-resources/feeding-tubes-for-people-with-alzheimers/
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If it were my mom, and she couldn't eat on her own and I had medical power of attorney, I'd say no. Quality of life vs. length of life…quality always wins in my opinion.
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What does her living will say ? My living will states that I do not want measures to extend my life. At 88 your mom has lived a full life.

you don’t give any information regarding the quality of your moms life.
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