Mailbox Response

The question was submitted 24/04/2008

Subject: Final stages of lewy body dementia

My Dad is currently unable to take food or liquid orally. At the moment he has a tube in but would feeding him through the stomach prolong his life? are there risks for the patient if he were to be fed through the stomach?

Answer from DementiaNet

The use of tube to provide artificial nutrition for those with end stage dementia is very controversial. Firstly, there is very little evidence that tube feeding alters survival or that it improves quality of life. There are risks associated with insertion of stomach tubes, i.e. an anesthetic is needed, a surgical incision is made, there is a risk of infection etc. In addition there is a risk of pneumonia associated with aspiration of stomach contents into the lungs. Many doctors do not place tubes in people with end stage dementia as a matter of principle. This is based on the idea that such treatment is futile, unnecessarily burdensome to the patient and represents over zealous use of medical technology. In addition, there is evidence that for patients who cannot take food or fluid there is a feeling of euphoria that accompanies this dehydrated state that is quite comforting for the patient. The other risk of this procedure is that the patient’s prior wish (advance directive) not to have tube feeding may be overridden by family members and health professionals.

The answer was published on DementiaNet 30/04/2008