Attitudes of relatives and nursing staff toward tuboenteral feeding in severely demented patients.
Elderly patients with advanced dementia present a challenge with respect to efficient nutrition and hydration because of oropharyngeal dysphagia and lack of patient cooperation. For increasing numbers of patients, long-term tuboenteral feeding (TEF) is an alternative for providing food and fluids, with the hope of reducing the risk of aspiration. The purpose of this study is to learn about the opinions and the attitudes of relatives and nursing staff regarding patients on TEF for at least one year. The study included all the demented patients on TEF in four skilled nursing facilities and four nursing wards. Researchers retrieved clinical data from patients' medical records and prepared a questionnaire to survey the opinions of relatives and staff members. The study included 111 patients: 89 on nasogastric tube (NGT) feeding and 22 on percutaneous endoscopic gastrostomy (PEG) feeding. The clinical condition of both groups was satisfactory, as reflected by albumin, hemoglobin, and Body Mass Index (BMI). Relatives of the demented patients as well as the staff members were ambivalent toward TEF. Although most of them called it an essential procedure for delivering food and fluids for life support, about the same number expressed concerns that TEF prolonged a life of suffering. Nevertheless, most relatives and staff members were resistant to the idea of withholding TEF. The data show that TEF does provide efficient nutrition and hydration to patients with advanced dementia, and it is used in accordance with the will of the relatives. Any change in the present approach regarding TEF in these patients should be preceded by discussions with their relatives.
Shmuel Harofe Hospital, Geriatric Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Emilia
E
Lubart
Arthur
A
Leibovitz
Beni
B
Habot
D000368:Aged; D001291:Attitude of Health Personnel; D003704:Dementia / Q000628:therapy*; D004750:Enteral Nutrition / Q000379:methods / Q000451:nursing*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D009752:Nutritional Status; D011795:Surveys and Questionnaires; D028761:Withholding Treatment