Nursing Home Feeding Tubes

In 2011, it was reported by the Centers for Medicare & Medicaid Services, in its annually published data compendium on nursing homes, that 5.9% of nursing home residents use feeding tubes as their primary means of obtaining nutrients.  Feeding tube use in nursing home residents is a somewhat controversial issue.  On one hand, it has been documented that feeding tubes are uncomfortable, highly invasive, and are considered by some to be an unethical form of treatment to residents, especially when careful hand-feeding of residents is a viable alternative.  It has been shown that feeding tube usage often correlates to a higher rate of resident agitation and the onset of bedsores.  However, there are some situations in which a feeding tube is absolutely necessary for sustaining life.  For example, some immobilized nursing home residents, or residents who are suffering from persistent malnutrition, can greatly benefit from the short-term use of a feeding tube.  The decision to use feeding tubes should be discussed with medical professionals, nursing staff, and the resident’s family or relatives.

What is a Feeding Tube?

There are two types of feeding tubes: nasogastric feeding tubes and abdominal feeding tubes.

nasogastric (NG) feeding tube is a tube inserted through the nose that extends down into the stomach, providing a connection between the two.  Nutrients are administered through the tube in the form of commercially prepared feeding formulas.  NG tubes are most commonly used when feeding premature babies and unconscious or comatose individuals but are sometimes prescribed for use by elderly individuals.

An abdominal feeding tube is a medical device that forms a port to the stomach through the abdominal wall.  A doctor implants a feeding tube during a surgery called a percutaneous endoscopic gastrostomy (PEG). The feeding tube facilitates feeding by providing food, liquid, and medications directly to the stomach while bypassing the mouth and esophagus.  A PEG is commonly used in people who have severe difficulty swallowing and other complex conditions that impact ingestion.

Potential Hazards Associated with Feeding Tubes

In addition to physical discomfort due to the presence of the feeding tube, there are other potential risks associated with the use of feeding tubes.  In the case of either type of feeding tube, there is the risk of developing digestive problems, such as bloating, cramping, diarrhea, constipation, nausea or vomiting. The abdominal feeding tube carries with it additional risks such as irritation, breakdown of the skin, or the possibility of developing an infection at the port’s insertion site. There is also the concern that the tube may clog, or become dislodged. If the tube becomes clogged, the user will not obtain any nutrients, and if the tube becomes dislodged, there is the risk that nutrient formula will be administered improperly.  Improper administration could cause accidental aspiration of the formula into the lungs, which can cause choking, asphyxia or pneumonia.

Many of the potential risks of using a feeding tube can be mitigated with proper care.  However, an elderly individual who needs a feeding tube likely needs it because he or she is unable to provide care for him or herself.  This means that the resident is reliant on nursing home staff to provide the requisite care and maintenance necessary to keep the feeding tube in proper working condition.  Failure to do so is a form of resident abuse and neglect.

If your loved one requires a feeding tube and you are concerned that he or she is not receiving proper care or consideration, please reach out to the Rooth Nursing Home Abuse and Neglect Law Firm online or by calling 877-356-3007.

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Centers for Medicare & Medicaid Services, Nursing Home Data Compendium 2012 Edition

American Geriatrics Society, Feeding Tubes in Advanced Dementia Position Statement, May 2013