Whether you are in a situation where an aging loved one needs medical intervention immediately or you are considering your own estate plan and need information on how to make informed choices for your Advance Directives, you need to educate yourself on the pros and cons of feeding tubes.
Feeding tubes provide liquid nutrition for those who find themselves having difficulty chewing and/or swallowing or are unable to physically eat at all. It can be a complicated decision to make and many medical professionals fail to provide thorough information to assist with the decision.
Why are Feeding Tubes Needed?
Someone may need a feeding tube for a variety of medical conditions and it may be only temporary or it may be permanently. Some neck and esophageal cancers, brain injuries or neurological conditions may prevent a person from having the ability to eat properly. It often occurs in severe dementia cases where patients develop dysphagia and lose the ability to swallow. If someone has been placed on a ventilator to help them breathe, then they likely also need some type of feeding tube.
There are two main types of feeding tubes:
Nasal Tubes
- Enter the body through the nose,
- Ends in either the stomach or small intestine,
- Typically used for short term conditions where the ability to eat normally is expected to return within a matter of weeks, and
- Can cause irritation in the throat and esophagus.
Abdominal Tubes
- Enter the body through the skin of the abdomen,
- Ends in either the stomach or small intestine,
- Typically used for long-term or permanent use,
- Complications may arise from the incision, and
- The most common type is called percutaneous endoscopic gastronomy (PEG) because it helps to prevent aspiration (food getting into the lungs).
The choice to use a feeding tube or elect an alternative such as careful hand feeding will likely be made by the agent named under a healthcare power of attorney. The healthcare agent will have to consider the risks and make an informed choice towards the best medical outcome while attempting to minimize the patient’s discomfort.
Sometimes careful hand feeding may be tried first, especially for alert dementia patients. It takes training to read the patient’s verbal and nonverbal cues to determine hunger or thirst. When determined, the caregiver will carefully feed the patient pureed food or thickened liquid and then observe for a period of time to ensure no aspiration has occurred. Unlike tube-feeding, hand feeding is time consuming and requires constant supervision.
We encourage families to discuss preferences for end-of-life care such as the use of ventilators and/or feeding tubes. We can help you make informed choices and put them in writing in a document referred to as Advance Directives or a Living Will. To discuss this further, contact one of the estate planning attorneys at Stouffer Legal in the Greater Baltimore area. You can schedule an appointment by calling us at (443) 470-3599 or emailing us at office@stoufferlegal.com.
