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Study: Tube feeding down among dementia patients in nursing homes

The number of patients given a feeding tube has dropped by half since 2000, but too many are still used, researchers say.

By Stephen Feller
While feeding tubes were once common for preventing starvation among nursing home residents with severe dementia, researchers at Harvard Medical School found they are used about half as often now as they were in 2000. Photo by Kzenon/Shutterstock
While feeding tubes were once common for preventing starvation among nursing home residents with severe dementia, researchers at Harvard Medical School found they are used about half as often now as they were in 2000. Photo by Kzenon/Shutterstock

BOSTON, Aug. 16 (UPI) -- Feeding tubes are used to prevent starvation of patients who cannot or will not eat food, but research has long questioned the benefits of using them with dementia patients because they not only fail to solve health problems, they often introduce new ones.

Researchers at Hebrew Senior Life and the Harvard Medical School found the number of patients receiving a feeding tube has decreased by about half in the last 15 years, but concerns about their continued use remain, according to a new study published in the Journal of the American Medical Association.

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Previous research has recommended careful hand feeding over tube feeding based on studies showing it can be as effective at preventing death and improving both comfort and functional status. Additionally, tube feeding is linked to discomfort, agitation and the use of restraints.

The massive decline seen in the new study, though stronger among white patients than black patients, is seen as a step forward in better, more appropriate approaches to treating people with severe dementia.

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"This decline parallels the emergence of research, expert opinion, and recommendations by national organizations discouraging this practice," Dr. Susan Mitchell, a researcher at the Hebrew SeniorLife Institute and lead author of the study, said in a press release.

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For the study, researchers analyzed data on 71,251 nursing home residents with advanced dementia and recent dependence for eating with a mean age of 84. Of the patients, 76.4 percent were women, 85.6 percent were white, 9.5 percent were black and 13.6 percent had a prior stroke.

Overall, the incidence of feeding tube insertion decreased from 11.7 percent in 2000 to 5.7 percent in 2014, a nearly 50 percent decline.

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For white residents, this represented a decline from 8.6 percent to 3.1 percent, and for black residents it dropped from 37.5 percent to 17.5 percent. The researchers report, however, that black residents remained far more likely than their white counterparts to receive a feeding tube.

Mitchell suggests that, moving forward, racial disparities need to be addressed, and greater efforts at discouraging overall tube feeding, and movement toward a palliative approach -- focused on comfort and care -- should be encouraged.

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