Tube Feeding on Hospice — Increased Risk of Your Loved One Suffering

Published on July 14, 2023

Updated on November 24, 2023

When a loved one is terminally ill, one of the most difficult decisions that families face is whether to use tube feeding or not. Tube feeding is a medical intervention that delivers liquid nutrition and hydration through a tube inserted into the stomach or intestine. While some people may think that tube feeding can prolong life or prevent starvation, the reality is that it may not offer any benefits for hospice patients. In fact, tube feeding can pose several risks that can negatively affect the patient's comfort, dignity, and quality of life. In this article, I will share some of the risks of tube feeding for hospice patients, based on my experience as a .

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Increased Risk of Suffering and Decreased Quality of Life

Tube feeding can have adverse effects on the physical, emotional, and psychological well-being of hospice patients. Here are some of the risks that I have observed in my practice:

  • Decreased Quality of Life: Tube feeding may not improve the overall quality of life for terminally ill patients. In fact, it can be burdensome and uncomfortable, causing distress and interfering with the patient's ability to focus on more meaningful aspects of their end-of-life journey. For example, tube feeding can prevent the patient from enjoying the and texture of food, which can be a source of pleasure and comfort. It can also interfere with the patient's ability to communicate, socialize, and express their emotions with their loved ones.
  • Increased : Inserting a feeding tube can cause , pain, and potential complications such as infection or injury to surrounding tissues. One of my own patients has had three in less than three months due to the feeding tube. These physical discomforts can add to the patient's overall distress and may not align with their goals of comfort and dignity in their final days. Moreover, tube feeding can cause side effects such as nausea, vomiting, diarrhea, bloating, and cramping, which can further reduce the patient's comfort and appetite.
  • Reduced Mobility and Independence: Tube feedings often require patients to be confined to bed or restrict their movement, limiting their independence and ability to engage in activities they enjoy. Most of the time, this can be eight to twelve hours of being forced to stay in a single spot. This loss of mobility can impact their sense of autonomy and overall well-being. It can also increase the risk of pressure ulcers, muscle atrophy, and joint stiffness, which can impair the patient's physical function and cause pain.
  • Potential Complications: Tube feedings can lead to complications such as , where food or liquid enters the lungs instead of the stomach. This can cause respiratory distress and increase the risk of , leading to further discomfort and hospitalizations. Furthermore, as the patient becomes closer to the actual dying process, the risk of these complications including fluid overload becomes abundant and this increases the amount of suffering the patient will go through. Fluid overload can cause swelling, , and heart failure, which can be life-threatening and distressing for the patient and their family.
  • Psychological Impact: Being dependent on tube feedings can have psychological implications for patients. It may contribute to feelings of helplessness, loss of control, and a sense of being a burden on their loved ones. Emotional well-being is crucial during the end-of-life phase, and tube feedings may not align with a patient's desire for peace and emotional closure. Some patients may feel guilty, angry, or depressed about their situation, and may lose their hope and motivation to live. Tube feeding can also create ethical dilemmas and conflicts among family members, who may have different opinions and beliefs about the patient's best interests.

Conclusion

Tube feeding is a complex and controversial issue that requires careful consideration and discussion among the patient, their family, and the hospice interdisciplinary team. The primary goal of is to provide comfort and support, focusing on the patient's physical, emotional, and spiritual well-being. Tube feeding may not achieve this goal and may instead cause more harm than good for hospice patients. Therefore, it is important to explore alternative approaches to nourishment and hydration that can be more beneficial and respectful for the patient. These include mouth care, small sips of fluids, and providing food that the patient enjoys and can tolerate. These methods can help the patient maintain their dignity, comfort, and quality of life, while honoring their wishes and values.

Resources

Is my loved one being dehydrated to death?

Artificial Nutrition and Hydration at the End of Life: Beneficial or Harmful?

Benefits and Risks of Artificial Nutrition or Hydration

Hospice Nutrition and Hydration for Your Patients

Eldercare Locator: a nationwide service that connects older Americans and their caregivers with trustworthy local support resources

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My Aging Parent Needs Help!: 7 Step Guide to Caregiving with No Regrets, More Compassion, and Going from Overwhelmed to Organized [Includes Tips for Caregiver Burnout]

Take Back Your Life: A Caregiver's Guide to Finding Freedom in the Midst of Overwhelm

The Conscious Caregiver: A Mindful Approach to Caring for Your Loved One Without Losing Yourself

Dear Caregiver, It's Your Life Too: 71 Self-Care Tips To Manage Stress, Avoid Burnout And Find Joy Again While Caring For A Loved One

Everything Happens for a Reason: And Other Lies I've Loved

The Art of Dying

Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying

Providing Comfort During the Last Days of Life with Barbara Karnes RN (YouTube Video)

Preparing the patient, family, and caregivers for a “Good Death”

Velocity of Changes in Condition as an Indicator of Approaching Death (often helpful to answer how soon? or when?)

The Dying Process and the End of Life

The Last Hours of Life

As an Amazon Associate, I earn from qualifying purchases. The amount generated from these “qualifying purchases” helps to maintain this site.

Gone from My Sight: The Dying Experience

The Eleventh Hour: A Caring Guideline for the Hours to Minutes Before Death

By Your Side , A Guide for Caring for the Dying at Home

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