Some Questions About Dementia and Tube Feedings

Fernández-Viadero, Carlos; Jiménez-Sanz, Magdalena; Verduga, Rosario; Crespo, David Revuelta

doi:10.1111/jgs.13551

Cited by 2 publications

(3 citation statements)

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“…Hence, the current guidelines based mostly upon experts' recommendations and the existing observational studies whose study design and overall quality have been questioned need to be interpreted with caution [28,30]. ese guidelines have been criticised as overestimating the futility of tube feeding and understating its benefits [25][26][27][28][29].…”

Section: Implications For Practicementioning

confidence: 99%

“…While several professional societies and experts have recommended careful hand feeding as the standard/ceiling of care for all individuals with advanced dementia who experience difficulty with oral intake [5,[22][23][24], other experts have argued in support of feeding tube placement [25][26][27][28][29]. Quite justifiably, the debate continues as there has not been any randomised controlled trial done to compare the benefits and burdens of tube feeding interventions with oral feeding in people with advanced dementia due to ethical concerns.…”

Section: Introductionmentioning

confidence: 99%

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Tube Feeding in Individuals with Advanced Dementia: A Review of Its Burdens and Perceived Benefits

Ijaopo

2019

Journal of Aging Research

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Background. Dementia remains a growing concern for societies globally, particularly as people now live longer. About 90% of individuals with advanced dementia suffer from eating problems that lead to general health decline and ultimately impacts upon the physical, psychological, and economic wellbeing of the individuals, caregivers, and the wider society. Objective. To evaluate the burdens and perceived benefits of tube feeding in individuals with advanced dementia. Design. Narrative review. Methods. Computerized databases, including PubMed, Embase, Medline, CINAHL, PsycInfo, and Google Scholar were searched from 2000 to 2019 to identify research papers, originally written in or translated into English language, which investigated oral versus tube feeding outcome in individuals with advanced dementia. Results. Over 400 articles were retrieved. After quality assessment and careful review of the identified articles, only those that met the inclusion criteria were included for review. Conclusion. Tube feeding neither stops dementia disease progression nor prevents imminent death. Each decision for feeding tube placement in individuals with advanced dementia should be made on a case-by-case basis and involve a multidisciplinary team comprising experienced physicians, nurses, family surrogates, and the relevant allied health professionals. Careful considerations of the benefit-harm ratio should be discussed and checked with surrogate families if they would be consistent with the wishes of the demented person. Further research is required to establish whether tube feeding of individuals with advanced dementia provides more burdens than benefits or vice-versa and evaluate the impacts on quality of life and survival.

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Section: Implications For Practicementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tube Feeding in Individuals with Advanced Dementia: A Review of Its Burdens and Perceived Benefits

Ijaopo

2019

Journal of Aging Research

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“…To the Editor : We appreciate the thoughts of Fernandez‐Viadero et al . and Flaschner and Katz on the recently updated and published American Geriatrics Society (AGS) Position Statement on Feeding Tube Use in Advanced Dementia.…”

mentioning

confidence: 99%