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A Physician’s Perspective: The Feeding Tube Decision

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It’s the question you may dread the most: The doctor has indicated that your care recipient will continue to lose weight and suggests a feeding tube.

Should you say “yes”?

We asked Dr. Terrie Ginsberg who specializes in Geriatrics at the University of Medicine and Dentistry, New Jersey School of Osteopathic Medicine, Center for Aging, Stratford, N.J., for her thoughts. “A feeding tube may be required if a patient needs surgery, was eating prior to surgery and the feeding tube will only be temporary during the recovery process,” Dr. Ginsberg explains.


“But, for a chronic situation, such as dementia, a feeding tube won’t provide adequate nourishment. The tube won’t change the mortality of the patient. It’s a more enjoyable experience to end life without a tube,” she says.

“What’s a better way to eat,” she adds, “with a little something in the mouth or nothing?”

Dr. Ginsberg encourages family members to have discussions about the repercussion of treatment options, so the family and the care recipient own the illness rather than the illness owning life. “We don’t want to take measures that will prolong suffering,” she adds.

To ensure that her patients and their families understand their choices about end-of-life care, Dr. Ginsberg schedules family meetings with patients and family member, often times when out-of-town family members return for visits with their care recipients. “The meetings help the family understand what’s going on with the patient,” she says. In the meetings, Dr. Ginsberg will discuss all aspects of an older adult’s lifestyle including medical problems, depression and sexuality. And, in these discussions, Dr. Ginsberg can help families tackle difficult relationship issues that may, if left unresolved, negatively impact a patient’s end-of-life. Dr. Ginsberg finds that often families will request heroic measures to save a patient because of their issues (unfinished business, guilt).

Dr. Ginsberg works to ensure the patient and families all contribute to a meaningful end-of-life experience. “Death,” she reminds us, “is a part of life.”

Resources

Handbook for Mortals, a guide for end-of-life care

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I began working with family caregivers in 1990 and launched CareGiving.com in 1996 to help and support them. Through my blog, I share words of comfort and offer coping strategies and tips. I also write opinion pieces about recent research, community programs and media coverage of caregiving issues. I've written several caregiving books, including "The Caregiving Years, Six Stages to a Meaningful Journey," "Take Comfort, Reflections of Hope for Caregivers" and "After Caregiving Ends, A Guide to Beginning Again." You can purchase my books and schedule a coaching call with me in our store.

2 COMMENTS

  1. I think this article is more an article about end of life than feeding tubes.

    In my experience feeding tubes provide a great way to get nourishment which is extremely important. There are many people that have illnesses that do not need to be terminal. Having good nutrition is important in beating the complications of illness and long hospital stays. And as far as comfort goes—tubes in the nose aren’t pleasant. My mother had a feeding tube for over 6 months before she recovered and it was key to her recovery.

    Louise M. Morman
    Founder
    Eldercare Learnings

  2. Hi Louise–Glad to hear from you–thanks for sharing your positive experience. As you note, the key to a decision about feeding tubes is their purpose–are they a temporary and appropriate treatment, as Dr. Ginsberg describes? Or, are they life-sustaining (a treatment that serves to prolong life without reversing the underlying medical condition), and in sustaining, cause discomfort? At life’s end, feeding tubes go against the natural dying process. I just added a great resource to the post which provides insights into the dying process.

    I’m so glad you posted because you’ve reminded me of one other suggestion: Before agreeing to a feeding tube, be sure to discuss with your care recipient’s doctor all the “What if?” questions. In particular, ask the physician: If my care recipient’s condition unexpectedly deteriorates, can we remove the feeding tube? The question of removing a feeding tube was the heart of the Terry Shiavo battle. Often times, the answer to this question will help you determine the best course of action.

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