Informed Decision-Making Surrounding the Use of Chronic Enteral Nutrition: Let's Talk the Talk

Authors: Joseph W. Shega, MD


Artificial nutrition through tube feeding is not unusual among persons with end stage dementia. It is estimated that about one-third of nursing home residents with advanced dementia are tube fed.1 This occurs even though the cited benefits of use; prolonging life, preventing aspiration, healing pressure ulcers, and providing comfort, do not appear to be supported by available evidence.2,3 The decision to place a feeding tube frequently occurs in an acute care setting and is made by a health care team that has not had a long standing relationship with the patient and family.4 Recommendations by the team are then often based on a “snapshot” of the patient so that appropriate medical decision-making is more challenging.

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