Is a Feeding Tube the Best Choice for My Loved One with Dementia?

It’s common for people in the late stages of Alzheimer’s or dementia to have trouble eating and drinking. In these cases, as a caregiver, you’re naturally concerned that your family member or loved one is getting proper nutrition. You may have heard that enteral feeding is an option, but you are wondering if it’s the best option for your loved one. 

One of the most difficult decisions a family must make is how to proceed when a loved one’s health declines. What caregivers find the most helpful is access to accurate information to help them decide. 

You might feel pressured to decide to seek a second opinion. That’s why it’s helpful to understand enteral nutrition and feeding tubes before you have to act quickly in your loved one’s best interest. To help put you at ease, we define a feeding tube, break down the facts, and the related costs.

What is a Feeding Tube, and When is it Used?

A feeding tube is a device placed into the body that delivers liquid nutrition. Common tube placement is through the nose and down the throat, or it can be placed through the belly so that food is delivered directly into the stomach through a percutaneous-endoscopic-gastrostomy tube (or PEG tube for short.)

Regardless of the location, they’re typically used when a person can no longer chew or swallow. An enteral feeding tube can be the go-to intervention when the cause of the eating problem is likely to improve or resolve. For example, doctors might recommend this approach when the person is recovering from surgery, stroke, or brain injury.

Enteral nutrition can also be appropriate when people have dysphagia (difficulty swallowing) but aren’t living in the late stages of a chronic and incurable illness. For instance, people living with ALS (Lou Gehrig’s disease) or Parkinson’s disease might be candidates for feeding tubes. 

It’s essential to understand the limitations of feeding tubes so you know what to expect. You should know that tube feeding doesn’t extend a person’s life, help with weight gain, increase strength, or regain skills. And when someone is in the late stages of dementia, a feeding tube can make them less comfortable. Towards end-of-life, the body shuts down through dehydration, and it’s natural for the person to reject food or drink, so force-feeding them can make the situation worse.

When Aren’t Feeding Tubes the Right Choice For My Loved One?

Feeding tubes are usually not the best course of action for helping people with late-stage Alzheimer’s or dementia. That’s because many people with dementia are irritated by the tube and try to pull it out. 

You should be aware of other risks that can complicate care or even compromise your family member or loved one’s health, such as:

• Bleeding, infection, skin irritation, or leaking around the tube

• Nausea, vomiting, and diarrhea

• The tube can get blocked or fall out

• Higher risk of getting pressure sores

• Higher risk of spitting up food, which could lead to pneumonia

Why Might a Doctor Recommend a Feeding Tube?

A healthcare professional will first consider the context when determining how to move forward. For example, if a patient is in the hospital, a feeding tube could allow the facility to release the person to a skilled nursing facility sooner. The healthcare team at a nursing home might be more inclined to recommend a feeding tube because it’s simpler and less time-consuming.

Regardless of where the person is receiving care, their situation is unique and often evolving. There may be situations where a feeding tube helps them, improves their quality of life, and relieves some of your worries. However, it’s your right as the caregiver to ask questions so you can feel heard. You deserve to have all the answers before choosing the best course of action.  

Are There Other Options Instead of a Feeding Tube?

If you and your loved one’s doctor conclude that a feeding tube isn’t the best idea, there are other ways to ensure your love is taken care of, including:

• Hand feeding: Feeding a person one bite at a time can be the best way to nourish people with advanced dementia.

• Offer a soft or pureed diet:  A person with acute health conditions might not be able to eat how they previously did. A soft diet can be easier to eat while still providing nutrition. A Pureed diet may be helpful, as it reduces the risk of coughing, choking, and aspiration.

• Use of a sippy cup or straw for liquids: Cups with lids or straws can be supportive when managing swallowing difficulties and can decrease the risk of choking.

Need Help?

If a feeding tube isn’t the best choice for your family member or loved one right now and you need help choosing pureed meals, our friendly Caregiving Specialists are here to assist. Call (800) 696-CARE or send an email to support@carewell.com. The team speaks English and Spanish and is available 24/7 to answer your questions.