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ljohnson7242 Asked June 2018

When should a TPN be removed from a patient refusing to eat after intestinal surgery?

(Total Parenteral Nutrition)

cwillie Jun 2018
I would think that having approved of the surgery the health care team would be highly invested in doing everything possible to bring about a positive outcome. If the doctor is recommending the tpn is discontinued I would be asking why since your father currently can not get nutrients in any other way. Is he advising it is time for hospice?

I don't know if you have the inclination to do a little reading at such a difficult time but I found the book Being Mortal by Atul Gawande helped me to understand how continued medical intervention can effect our quality of life in it's last stages.

DeeAnna Jun 2018
Tell him that it is his breakfast, lunch and supper in a bag or bottle and that it has the nutrients and vitamins that will make him feel better quicker. It is like "Ensure", only it is specially made to be given through the veins and cannot be given orally. (And Ensure or Boost cannot be given through the veins or the IV.) DO NOT threaten to have a feeding tube put in as Alzheimer's patients have a tendency to pull them out and the feeding tube cannot be discontinued except by the hospital's or nursing home's Ethics Committee .

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ljohnson7242 Jun 2018
Thanks for your responses!! He is 93 and has Alzheimer's. He just had a gangrenous gallbladder removed. I've never heard of a TPN before and don't want the doctor taking it out too quickly. I was looking for reasons to give him to keep it going. Daddy is just SO weak and not eating because of the surgery.

jeannegibbs Jun 2018
Assuming the person is not incompetent to make medical decisions for themselves, The device should be removed when the person wants it removed.

JoAnn29 Jun 2018
What kind of surgery? The TPN maybe needed until they heal.

cwillie Jun 2018
I think an answer is going to depend on how old the person is, what their comorbidities are and what their prognosis is. Can you provide more details?

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