Tube feeding in the demented elderly with severe disabilities

Efraim Jaul*, Pierre Singer, Ronit Calderon-Margalit

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

Background: Despite the ongoing debate on tube feeding of severely demented patients, the current approach in western countries is to avoid feeding by tube. Objectives: To assess the clinical course and outcome of demented elderly patients with severe disabilities, by feeding mode. Methods: The study was conducted in a skilled nursing department of a major psychogeriatric hospital in Israel. Eighty-eight patients aged 79 ± 9 years were followed for 17 months: 62 were fed by nasogastric tube and 26 were orally fed. The groups were compared for background characteristics, underlying medical condition, functional impairment, clinical and nutritional outcomes, and survival. Results: Tube feeding had no beneficial effect on clinical and nutritional outcomes or on healing preexisting pressure ulcers, compared with oral feeding. Very few patients on tube feeding showed signs of discomfort, partly because of low cognitive function. Survival was significantly higher in the tube-fed patients (P<0.001), which could be partly explained by the different case mix (i.e., the underlying diseases) Conclusions: Tube feeding seems to have no nutritional advantage in severely demented elderly patients. Median survival was longer in tube-fed individuals who had no acute co-morbidity. However, since tube feeding does not add to patient pain and discomfort, it should not be contraindicated when it complies with the values and wishes of patients and their families.

Original languageAmerican English
Pages (from-to)870-874
Number of pages5
JournalIsrael Medical Association Journal
Volume8
Issue number12
StatePublished - Dec 2006

Keywords

  • Demented elderly patients
  • Severe disabilities
  • Tube feeding

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