Nutrition continues to be a problem for people with advanced dementia or Alzheimer’s. Patients are less able to eat independently, so they need help. In particular, the problem of the effectiveness of nasogastric tubes for feeding arises. It has been established that they can be highly effective, but they also create risks of strangulation and fear in the patient (Candy et al., 2009). As a consequence, the use of assisted oral feeding as a patient support tool is recommended.
Regarding nutrition, the essential ethical component of health care delivery, caring, should take precedence. Caring for nutrition issues is an act of sincere support, so using probes becomes an obstacle in this matter since it does not require the presence of an assistant. Invasive techniques place an additional burden on the body, especially when protein components are deficient (Candy et al., 2009). In addition, the survival factor remains unstable because survival may be related to comorbidities. Studies Candy et al. (2009) and Chou et al. (2020) found that the presence of comorbid support becomes most important because without it, the risks of asphyxia increase, so staff involvement in feeding is necessary. Chou et al. (2020) also found that the risk of pneumonia increases when feeding with a tube. Training staff in proper oral feeding can have the same positive effect as using probes. Moreover, it may benefit social proximity, demonstration of care, and attention. Oral feeding may be a new solution in supporting individuals with dementia because it draws attention to important aspects of helping such individuals.
Thus, the effectiveness of probes in feeding persons with dementia/Alzheimer’s disease remains high. However, because of the risks, other less invasive methods are recommended. In particular, assisted oral feeding may have the advantage of avoiding significant risks of pneumonia, having social proximity, and developing a more trusting relationship with patients. Because the survival factor is not reliably established with tube feeding, noninvasive methods may serve as new supportive tools.
References
Candy, B., Jones, L., & Sampson, E. L. (2009). Enteral tube feeding in older people with advanced dementia: Findings from a Cochrane systematic review. International Journal of Palliative Nursing, 15(8), 396–404. Web.
Chou, H. H., Tsou, M. T., & Hwang, L. C. (2020). Nasogastric tube feeding versus assisted hand-feeding in-home healthcare older adults with severe dementia in Taiwan: a prognosis comparison. BMC Geriatrics, 20(1). Web.