Surrogate decision makers' attitudes towards tube feeding in the nursing home

Archives of Gerontology and Geriatrics
E Somogyi-ZaludE Olson

Abstract

In the nursing home, a widely accepted medical practice is to recommend the initiation of long term tube feeding in residents with eating difficulties. However, frequently the nursing home resident has dementia, lacks decision-making capacity, and has no advance directives to guide the physician and the family member(s). Therefore, the family member or another surrogate decision maker has to make the difficult decision of whether or not to consent to the placement of a feeding tube. We surveyed 50 English speaking surrogates of nursing home residents who were on a feeding tube for at least 6 months. Each surrogate was contacted by telephone and was administered a 16-item structured questionnaire. Statistical analyses included frequency distributions, and the Wilcoxon signed rank test for two related samples. Most surrogates rated the residents' quality of life as poor or extremely poor. Yet, 78% of the surrogates perceived tube feeding to be beneficial, 62% would repeat their initial decision to initiate tube feeding, and 68% would not consider removal of the feeding tube. Their leading concerns were medical complications, tube feeding's impact on each resident's quality of life, and adequacy of nursing care. The surrogates wer...Continue Reading

References

Jun 1, 1992·Journal of the American College of Nutrition·C T HendersonT P Miles
Feb 1, 1988·Archives of Internal Medicine·J O CioconC J Foley
Jan 20, 2000·The New England Journal of Medicine·M R Gillick

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