What to expect with a feeding tube?

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What to expect with a feeding tube?

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Mother in law is getting feeding tube because she has not ate in 2-3 weeks. Was diagnoised with small cell lung cancer and hospice starts next week. What can we expect with the feeding tube?

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My Mom has a feeding tube and does great with it. She has Parkinsons. A long hospitalization was the reason it was placed. She eats pureed food and drinks thickened liquids too. I am her Son and Caregiver and run the tube feed during the overnight hours. Three cans of therapeutic nutrition at a rate of 60/720. I also administer her medications through it. The feeding tube is great because it helps with her overall nutrition and really have had no complications with it whatsoever.

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I have had a J tube now for over a year, without it I would probably be dead because i had become severely emaciated and following surgery refused to eat because the diet was so horrible and I felt nauseated and had constant diarrhea.
At first I refused all tube feeding but I was so bad I was persuaded to have TPN (Total parental nutrition through a vein in my chest. I had become so anxious in the hospital that I refused to have any proceedure without heavy sedation. As I progressed towards being released the TPN could not be continued and a J tube through the abdominal wall was recommended. i was warned that medicare only approved 25% of these for reimbursement. By then I had failed three swallowing tests and it was approved, again I would not do it without heavy sedation. I was just too frightened. There can be a lot of problems with these tubes as someone said they can become infected and unless you are very vigilant easily clog. Now I have had it changed and bigger one put in more securely as the first kept slipping out and although it is more uncomfortable it works far better and I can easily manage it at home. I am now at the point where I can get about half my nutrition by mouth. Cans of feed are delivered once a month along with bags and irrigation syringes. It does not show under my clothes but I do have to avoid tight waist bands. My hope is eventually to have it removed but my swallowing difficulty still remains and I can easily choke. I am 77 and do not have a terminal illness unless you count my very bad heart which naturally could do something nasty at any time. I was offered hospice a couple of times but refused and said I intended to get better which I am slowly doing but the J tube has played a significant part in that. For someone without dementia who can make a recovery I would certainly recommend using one but not for some one who clearly has a terminal illness and this will merely prolong their suffering. There is also the advantage of being able to give liquid or crushed medications via the tube which I did for a while. Of course there are pros and cons to any situation but I do have the experience of living with one so in my case it certainly was the right decision. I use mine overnight and it does take 5-10 hours depending on the volume but I can turn off the pump and just carry the bag around for things like bathroom visits or going to the kitchen. i had a lot of trouble with the connections coming apart with the first tube and it does make a nasty sticky mess but the new one has a more secure connection and I am not likely to pull it out myself. (Which I would do in a heart beat if i felt my quality of life had gone.)

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At this point in time (and since the 80's), it is possible to have feeding tubes inserted through the abdomen, NOT THE NOSE OR THROAT, and this is no doubt a much more comfortable way to receive one's feedings. If the person is talking and has at least a fair amount of energy, why not give them a fair chance to live and graduate to "bolus feedings?" (liquid is inserted thru the g-tube 3 or 4 times per day and medications can go thru the tube as well). During this time it is also common for Speech Therapists to work on swallowing skills. Some people recover those skills soon, some later, and some apparently never (which may have to do with the skill level of the Speech therapist as well as their own physiology...). Some Speech therapists are certified in "VitalStim", an adjunct to therapy where electrodes are placed on the throat, and which can help accelerate the swallowing process in some people. Every individual case is different...Evaluate carefully and hope that you can get the best therapist possible if they do have some kind of tube. (Medicare unfortunately will not continue to pay for therapy unless the patient makes pretty measureable and possibly unrealistic progress...so you may have to, at some point, pay out of your own pocket if you want to continue this therapy...).

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An NG tube will be inserted through the nose and is frequently pulled out by a confused, sick, elderly person. They are uncomfortable to say the least. A GI tube will be inserted directly into the stomach and is actually easier to deal with but needs to be placed surgically. If someone is dying they do not want to eat. So if you are looking to prolong just for the sake of prolonging life I would think about the persons wishes and their quality of life. Many prayers to you...

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I do not have anything good to say about a feed tube. I think it is a fast and easy fix to the problem of geriatrics not eating. The patient loses the pleasure of tasting food. The area where the tube is will get infected or irritated. Some patients will pluck or pull on the tube. Then it will be reinserted. Just nothing good about a tube.
There are other options.
I would look into another solution.

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The most important question is not how eager we are to let someone die - but rather - what kind of life are we giving them and for how long? That is the question each family must answer and why it is so important to discuss such issues well in advance of need.

I do not think that just because someone does not opt for a feeding tube that it automatically puts them into the category of someone who is eager to see their loved one die. No one wants that. Often we do the tube because WE cannot face losing them. IF they have the opportunity to improve and be well again - or have some semblance of a normal life for a while - I am for it 100%. If not, then often it is done for reasons other than their well being.

We can do it out of fear, guilt, whatever. Everyone, no matter what age, should let their end of life wishes in this regard be made known to their families - preferably more than one family member. Then if this serious decision must be made - it can be made according to the wishes of the patient - since the decision was made when they were well and thinking clearly.

There are many ways to make someone comfortable.

A friend of mine fed her mother through a tube for nearly a year. Her mother made the decision and it worked out pretty well. I am not 'anti tubes' - only anti prolonging of suffering when there is no hope for recovery.

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My dad had ALS, Lou Gehrig's Disease. ( 1978) He luckily was cared for at home & had a G-tube the last 3 months of his life. Swallowing anything by mouth was too risky. It enabled my mom to keep him hydrated, to receive Ensure & ground food to keep up his strength somewhat. Also...medications could be given. For him, it was a good thing to have. He was always alert & gave him a little more time.

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I have had loved ones with the feeding tubes (abdominal) and this was so useful and comforting!!! When someone is having severe trouble swallowing, the feeding tube reduces the fear and pain on part of the person who has it. This way nutrition can be given and the patient kept more comfortable without gagging or choking on food which is pretty stressful when you are feeding someone who has swallowing problems. I think this is a good thing. Too many people are too eager for someone to die.

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My mother in law changed her mind about tube almost immediately after consenting. She had it pulled 36 hours later and he passed away 3 days later. He was never going to get better, had been in intensive care 6 weeks with a completely eroded esophagus. He couldn't eat or drink - not even a sip. He was 80 years old and never wanted to live like that. Why she did it is beyond me - I do think doctors push it - more $$$ for the hospital, sadly.

Everyone has to make their own difficult decisions and I would never fault you for trying to keep someone alive because saying good bye is so very hard to do. Wish that WISHES could make everything ok for you.

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How old is she. AFTER my MIL consented to a tube (surgically done into his abdomen) for her hubby and it did not help and then she asked that they remove it - I did some research on feeding tubes.

Personally, unless the person was young and had very good prospects of a FULL recovery - I would not consent to it. Especially the surgically installed ones. My FIL had a condition that would NEVER EVER be made right and the tube did nothing but prolong his agony.

My online research indicated that tubes are done far too often on folks who do not have good prospects for recovery and it just prolongs their life an average of six months and that life was NOT a good life, but usually spent in a nursing home.

Legally, the doctors is NOT supposed to remove a tube once it is installed. The doctor who removed the tube from my FIL was yelled at by another doctor who was afraid we would sue if he died. It can get pretty nasty.

So, consider what kind of life you are prolonging. Will she recover from what is ailing her or will she just continue to go downhill. Did she consent - is it what she wants?

These are tough questions and you have a tough decision. Letting someone we love 'go' is very, very hard. So, whatever your decision - I hope you will be ok with it and you are in my thoughts today.

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If it is a feeding tube through her nose she could get some gagging. The important thing is to see the spot (usually a number) where it enters her nose and is taped in place. Make sure that it does not dislodge or the feeding could end up in her lungs.

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There is also one that is inserted surgically into the stomach. It will all depend if she is still home and coherent or what. Its a fairly easy process on feeding. I hope all goes well with the feeding tube, and hospice care. You should get all of your questions answered by the doctors or nurses that insert the feeding tube.

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You can expect to feel no pain. You do not state whether it is an NG tube (one that runs through the nose - nasal-gastric tube), or one that is thread down her throat. Unless she has a DNR (Do not resuscitate) order, there will be means by which she will be kept alive, however, entering hospice is death within six months. Prepare yourselves for the inevitable...my prayers are with you.

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Why are they putting in a feeding tube? She's dying and this is going to prolong that process. Ask more questions of her doctors.

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