Scenario 2: Tube feeding decisions

Dad is eating virtually nothing now; should the community nurse put a feeding tube into his stomach?”

  • People in the end stage of dementia typically lose weight, have little interest in food and have difficulty in swallowing. These are all part of their gradual decline.
  • Watching a loved one losing weight and not eating is a painful experience, because providing food is associated with nurturing, care and social interaction.
  • A person’s family may want to force food on the person or else have them fed by tube through either:
    • a nasogastric (NG) tube inserted through the nose and back of the throat into the stomach, or
    • a percutaneous endoscopic gastrostomy (PEG), a tube that is inserted directly into the stomach through an incision in the abdomen.
  • Families should make sure staff fully explain the issues involved so they can make a decision that is in the best interest of their loved one. The family should ask staff to demonstrate how to provide food and fluids safely by mouth, such as giving small amounts of food and fluids that the person likes and providing this in a relaxed and nurturing atmosphere.
  • While tube feeding can be useful for people who cannot eat or drink but are otherwise well, it is usually not appropriate for people at the end stage of dementia. It can be painful, very distressing or uncomfortable for the person, can lead to medical complications, and it interferes with the natural process of dying.