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The Reality of Tube Feeding in Nursing Homes

The nursing home abuse lawyers at Pintas & Mullins want to highlight an extremely important but seldom discussed issue affecting residents: the use of feeding tubes in nursing homes and hospitals. Tube feeding is meant to provide nutrients to those who cannot eat on their own. It has become increasingly clear, however, that aside from emergency situations, tube feeding has no real benefits and actually causes severe harm.

Tube feeding (also called enteral nutrition) delivers liquid nutrition directly to the patient's stomach or small intestine. The process usually involves placing a 20-inch silicone tube through the nose, into the back of the throat, and into the stomach or small intestine, without any type of anesthesia or sedation.

This is also how inmates in places like Guantanamo Bay are fed when they go on hunger strikes. One inmate who was force-fed said he had "never experienced such pain before." Currently, in Israel, a fierce debate is ongoing about the ethics of forcing inmates to be tube-fed.

Numerous studies show that using feeding tubes in patients with dementia is particularly dangerous. Research finds that dementia patients with feeding tubes are more than 2 times more likely to develop new bedsores, and those with existing bedsores are less likely to heel while they had feeding tubes in place. This makes sense since tube feeding requires the resident to be immobile lying in bed.

Unfortunately, dementia patients are routinely placed on feeding tubes at the request of families or their physicians. One study from 2009 found that more than one third nursing home residents with advanced cognitive dementia were tube fed. Researchers found no evidence of increased survival in these residents, no evidence of benefit in terms of nutritional status or bedsore prevention, and no improvement in infections or aspiration pneumonia.

Feeding tubes can also become clogged, bent, dislodged, or otherwise defective, posing even greater harm to the resident.

For-Profit Incentives

So why do nursing homes continue to use tube feeding for so many residents? Money. It is far cheaper to place a resident on a feeding tube than it is to hand feed them. A study by a geriatrics professor at Harvard Medical School showed that residents in for-profit nursing homes are much more likely to have feeding tubes.

Nursing homes in urban areas, without dementia units, and with more than 100 beds are also more likely to use feeding tubes. There are many reasons for this. Larger, for-profit nursing homes are more likely to be understaffed, meaning employees do not have the time to hand feed residents even if it is in their best interest. Facilities can also charge much higher rates for feeding tubes, which is paid by insurance, so facilities are paid for tube feeding rather than paying their staff to take the time to carefully hand feed.

Eating and swallowing typically become a problem in the final, terminal stages of dementia. Families, hoping to extend life as long as possible, often request feeding tubes. What they may not take into account is the comfort and quality of life for their loved one's final days. Families should consider that, in many cases, the inability to eat or drink is itself a sign that the person is nearing the end of their life. Inserting a tube through painful means will only add to their suffering.

It is important to note that there are some cases where tube feeding is necessary, such as after surgery or severe trauma. But the vast majority of residents currently on feeding tubes are suffering unnecessarily and without benefit.

Our team of nursing home negligence lawyers offers free case reviews to concerned residents and families nationwide. We accept cases involving serious injury or wrongful death from abusive or negligence nursing homes.