Monday, August 25, 2014

A professional weighs in on feeding tubes, dementia, and EOL

I have written on this topic before. When End of Life comes, the body knows what to do. It shuts down slowly, part by part.

A person with dementia, who experiences many pneumonias, and chokes while eating, is at risk. Aspiration pneumonia, and the ensuing antibiotics, is hard on someone dying.
A feed tube adds a difficult surgery, with complex care, as brain function slows down.
But contrary to popular belief, a feeding tube does not prolong life in a patient with dementia. It actually increases suffering. A stomach full of mechanically pumped artificial calories puts pressure on an already fragile digestive system, increasing the chance of pushing stomach contents up into the lungs. And surgically implanted tubes are a setup for complications: dislodgments, bleeding and infections that can result in pain, hospital admissions and the use of arm restraints in already confused patients.

But maybe most important, the medicalization of food deprives the dying of some of the last remnants of the human experience: taste, smell, touch and connection to loved one.

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