Featured Research

from universities, journals, and other organizations

Families need to know more about feeding tubes for elderly dementia patients

Date:
May 5, 2011
Source:
Brown University
Summary:
In hundreds of interviews in five states with family members of persons who had advanced dementia, researchers found that their decision-making process for whether to insert a feeding tube often lacked necessary information for informed consent.

Despite evidence that feeding tubes do not improve survival rates or quality of life for elderly patients with advanced dementia, their frequency of use varies widely across the states. A new survey of family members finds that discussions surrounding the decision to place feeding tubes surgically are often inadequate.

Advanced dementia is a terminal illness that often affects a patient's ability to eat. In prior research, Joan Teno, professor of community health at Brown University, has documented a striking variation in feeding tube insertion rates.

To gain insight into the decision process and how it is informed by doctors, Teno and colleagues led a five-state survey regarding feeding tube insertion with family members of elderly patients who had advanced dementia. The results, published online in advance by the Journal of the American Geriatrics Society, will appear in the May 13 print issue.

"Our results suggest that in these states with a high rate of feeding tube insertion we need to improve decision making so that the decision to insert a feeding tube is based on a process that elicits and respects patient's wishes," said Teno, the paper's lead author.

Among the study's key findings:

  • 13.7 percent of family members who said their family member received a feeding tube stated that medical providers inserted the tube without discussing it first;
  • 11.2 percent said they felt pressured by the physician to put in a feeding tube;
  • 38.2 percent believed that that physician was strongly in favor of feeding tube insertion;
  • 41.6 percent of the time the discussion regarding feeding tube insertion lasted less than 15 minutes;
  • 39.3 percent did not discuss the risks of feeding tubes.

The study sample size was 486 people in five states, mostly sons and daughters who were either the persons named in an advance directive or were the person identified as the surrogate decision maker for a patient with advanced dementia. Teno led a group of researchers from Brown, the Hebrew Senior Life Institute for Aging Research in Massachusetts, and the University of Texas Southwestern Medical Center in asking people to describe the communication they had with physicians surrounding whether to insert a feeding tube for their loved ones.

The five states were selected because they had especially high (Texas, Alabama, and Florida) or very low (Massachusetts and Minnesota) rates of intubation. Extrapolating the survey group to the entire population of the five states, much like public opinion polls do, the figures would represent 9,652 cases of elderly patients with eating problems while dying from advanced dementia.

Some satisfaction

Despite research studies that question the value of feeding tubes, 32.9 percent of people in the survey said the feeding tube did improve quality of life for their loved ones. That was more than the 23.4 percent who said they regretted using a tube.

Teno cautioned against becoming complacent about the level of satisfaction family members recall, especially after dialogues that sometimes lack all elements necessary for fully informed consent.

"I watch people who make decisions that are really difficult," she said. "To continue on they have to make peace with their decisions."

In addition to Teno, authors from Brown were Sylvia Kuo, Pedro Gozalo, Julie Lima, and Vincent Mor; the author from Hebrew Senior Life was Susan Mitchell; the author from UT Southwestern was Ramona Rhodes.

The work was funded by the National Institute on Aging.


Story Source:

The above story is based on materials provided by Brown University. Note: Materials may be edited for content and length.


Journal Reference:

  1. Joan M. Teno, Susan L. Mitchell, Sylvia K. Kuo, Pedro L. Gozalo, Ramona L. Rhodes, Julie C. Lima, Vincent Mor. Decision-Making and Outcomes of Feeding Tube Insertion: A Five-State Study. Journal of the American Geriatrics Society, 2011; DOI: 10.1111/j.1532-5415.2011.03385.x

Cite This Page:

Brown University. "Families need to know more about feeding tubes for elderly dementia patients." ScienceDaily. ScienceDaily, 5 May 2011. <www.sciencedaily.com/releases/2011/05/110505103249.htm>.
Brown University. (2011, May 5). Families need to know more about feeding tubes for elderly dementia patients. ScienceDaily. Retrieved October 23, 2014 from www.sciencedaily.com/releases/2011/05/110505103249.htm
Brown University. "Families need to know more about feeding tubes for elderly dementia patients." ScienceDaily. www.sciencedaily.com/releases/2011/05/110505103249.htm (accessed October 23, 2014).

Share This



More Health & Medicine News

Thursday, October 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
Powered by NewsLook.com
U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

Newsy (Oct. 22, 2014) Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
Powered by NewsLook.com
US to Track Everyone Coming from Ebola Nations

US to Track Everyone Coming from Ebola Nations

AP (Oct. 22, 2014) Stepping up their vigilance against Ebola, federal authorities said Wednesday that everyone traveling into the US from Ebola-stricken nations will be monitored for symptoms for 21 days. (Oct. 22) Video provided by AP
Powered by NewsLook.com
Doctors Help Paralysed Man Walk Again, Patient in Disbelief

Doctors Help Paralysed Man Walk Again, Patient in Disbelief

AFP (Oct. 22, 2014) Polish doctors describe how they helped a paralysed man walk again, with the patient in disbelief at the return of sensation to his legs. Duration: 1:04 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins