Pros and Cons of Feeding Tubes
With the approach of end-of-life in Santa Clara and elsewhere, it’s not uncommon for a hospice patient to lose his or her appetite due to the rapid shut down of organs and systems. Once the body starts to shut down, it doesn’t need fluids or sustenance like it used to. Thus, a difficult decision arises for the family members: should their loved one get a feeding tube inserted to deliver the nutrients they need to sustain life? Thankfully, this isn’t a decision you have to make alone. The hospice care doctor can provide guidance on this matter. In the end, the family’s health care proxy has to make the final decision.
Feeding Tube Awareness Week took place February 7 through 11, 2022, giving us a reminder of the gravity of this decision. In addition to deciding whether or not to insert a feeding tube, the family also has to decide when to insert it and when to remove it.
Defining a Feeding Tube
Feeding tubes, or nasogastric (NG) tubes, provide liquid nutrition to those who are having difficulty chewing or swallowing or who cannot eat on their own. It’s placed up through the nose, snaking down to the stomach to provide nutrition for a short period of time, according to the NIH. When it’s needed for the long-term, then a gastric, or G tube, is inserted directly into the stomach via an abdominal opening. For the purposes of this article, we’ll concentrate on short-term NG tubes.
Here at Pathways Home Health and Hospice, we take the comfort level of patients and their families very seriously, setting aside time to sit down with both parties to discuss the pros and cons of feeding tubes so you can come to the best decision possible. Gaining the information, resources, and even counseling you need, will be key in this decision.
Why Feeding Tubes May be a Good Decision
Under the right circumstances, a feeding tube can considerably improve the person’s quality of life. They can relieve gas, bloating, nausea, and vomiting. But the main goal of a feeding tube is to make sure food or liquid doesn’t make its way to the lungs, resulting in aspiration pneumonia. A feeding tube is also easily removed by a member of the care team if need be, in a matter of seconds.
Today’s Dietitian says that nutrition support via feeding tube for hospice patients reduces physical deterioration, improves quality of life, and prevents the emotional effect of “starving the person to death” — something families really struggle with.
Why Feeding Tubes May NOT be a Good Decision
There are side effects of inserting a central catheter, mainly its ability to cause infection, sepsis, vein clots, collapsed lungs, cardiac arrhythmias, and electrolyte disturbances — which are all life-threatening. NG tubes may lead to choking and discomfort, and when not inserted into the trachea properly, pneumonia can result. Such tubes have been known to cause erosions and abrasions within the nasal passages, stomach, and esophagus, which can cause bleeding. Sometimes patients dislike the tube so much they try to yank it out, leading to the need for restraint. In turn, this can lead to agitation and anxiety, not to mention injury. According to Healthline, NG tubes can also get blocked, dislodged, or torn, leading to the formation of ulcers or infections of the throat, sinuses, esophagus, or stomach.
In making the decision to insert a feeding tube in your loved one, there are some things to think about:
- If a feeding tube is declined, the patient is given foods by mouth in small increments as tolerated. They may not be consuming enough calories to maintain or put on weight, but it’s important to remember that they don’t feel hunger in the same way healthy people do.
- Comfort measures can be taken to make sure the patient has no pain or shortness of breath.
- There are different types of feeding tubes. Enteral feeding tubes, for example, deliver water, liquids, or pureed foods, and can be partial (giving them just some of the nutrients they need) or total (giving them all of the basic nutrients they need to maintain weight and keep up their energy).
When looked at from a hospice perspective, the patient’s inability or lack of desire to eat is an indication that the end-of-life journey has begun. It’s not uncommon for family members to agonize greatly over the decision to insert a feeding tube, withhold a feeding tube, or discontinue artificial nutrition or hydration. This is understandable. We as humans are programmed to provide sustenance to others as a sign of love, protection, and nourishment. This instinct is so deeply ingrained that it gives many people pause when they are faced with such a momentous decision. This is why it helps to have the opinions of your hospice care team to help guide you in a clinical decision based on facts rather than emotions.
Contact Pathways Home Health and Hospice
For more guidance and explanation on feeding tube options for your loved one, consult with our hospice care team in Alameda County. Contact us today at 888-978-1306.