- In appropriate situations, tube feeding provides an excellent source of nutrition for older adults.
- Complications from tube feeding do occur and can be managed in the home setting.
- Home health care nurses can provide the support you need to stay in your home.
George is a 93-year-old man who requires ongoing tube feedings. He had been in and out of the hospital every month to two with a diagnosis of aspiration pneumonia. George’s wife of 40 years died two years ago. Prior to her death, she helped care for George. Together they made the decision to have a permanent feeding tube placed because George was having difficulty with chewing and swallowing, a condition known as dysphagia. George was otherwise in good health.
George has been living in a condominium on his own. He has one daughter who is in poor health and lives an hour away. George is having trouble self-administering his medications and his tube feedings.
What are tube feedings?
Tube feedings are a way to deliver liquid nutrition and medications to individuals who have trouble chewing or swallowing.
Tube feeds contain:
- Vitamins
- Carbohydrates
- Proteins
- Fats
- Minerals
- Water
Tube feedings can be used as a temporary stopgap for someone recovering from an illness, or they can be permanently implanted for those who have a more permanent condition such as a traumatic head injury or a neurological disorder that makes eating difficult.
Feeding tubes can be temporarily inserted through the nose or mouth. The tube travels down the esophagus, delivering nutrients into the stomach or the small intestine. However, because these tubes eventually irritate the nose, throat, and esophagus, they are only used as short-term solutions.
A more permanent solution is to insert the feeding tube through a surgical incision in the abdominal wall. These tubes may terminate in the stomach or small intestine.
Why would an older adult need tube feeding?
There are many reasons why individuals, both young and old, may need tube feeding, such as living with:
- Treatment from a head and neck cancer
- Dementia
- Stroke
- Parkinson’s disease
- Head trauma
- Traumatic brain injury
- Alzheimer’s disease
- Amyotrophic lateral sclerosis (ALS)
- Cancer (head and neck, gastrointestinal)
- Severe Crohn’s disease
- Bowel obstruction
- Esophageal stricture or narrowing
- Ulcerative colitis
- Swallowing coordination problems
Living with tube feeding
Tube feedings can provide complete nutrition as well as a convenient way to administer medications. Here are some tips for adjusting to life with tube feeding:
- Ask for liquid forms of medication, so that it does not need to be crushed.
- Tube feed products can meet a variety of nutritional requirements. Learn which ones are the best suited to meet your needs.
- Tube feed products are available for those with lactose intolerance.
- Tube feedings can provide the nutrition needed to keep fatigue and weakness at bay. It can also provide the nutrition needed to ensure your immune system functions optimally.
- Avoid putting other food down a tube to prevent tube blockages.
- When ordering liquid medications, ask for sugar-free, so they don’t stick to the tube.
- Have a mortar and pestle handy in case you need to crush any medications.
- Keep your pump charged at all times.
- Have a spare set of all supplies on hand.
- Physical activity can help prevent constipation. Ask what activities are safe for you.
Complications from tube feedings
Placing a feeding tube is a surgical procedure. There is the risk of complications from the surgery or infection at the surgical site.
Potential complications of feeding tubes include:
- Poor healing at the incision site
- Infection
- Clogged or plugged tubes
- Pulling the tube out
- Tube leakage
- Skin breakdown
- Diarrhea
- Pneumonia
- Feed intolerance
- Constipation
- Perforations (tears) in the intestines
- Abdominal infections
For the past two years, George has been administering his tube feedings. Increasing fatigue and difficulty with fine motor control have made preparing his feedings more difficult. His tube has clogged twice in the last week. He has had to enlist the help of a neighbor to unclog it. George values his independence and is seeking a different solution.
What are the signs of tube feeding intolerance?
It can take time to find the best tube feeding routine. Feeding too fast can increase the risk of side effects. If you are experiencing nausea, call your healthcare team. They may recommend decreasing the volume of your tube feed or slowing the rate of delivery.
How long do people survive on tube feeding?
The decision to implant a permanent feeding tube can be difficult. While it is upsetting to think about a loved one no longer able to eat or drink, placing a feeding tube is not without risks.
In some cases, older adults with dementia may be unable to express their wishes regarding feeding tubes, and the decision falls on their medical power of attorney or legal guardian.
George was in otherwise good health. However, his difficulty swallowing was putting him at increased risk of aspiration pneumonia. This serious condition occurs when food or liquids enter the lungs, increasing the risk for infection.
A decrease in desire for food and liquids is a sign that the end of life is approaching and, in some cases, eating or drinking at that point causes discomfort. The length of time an older adult will survive with a permanent feeding tube is unknown, but research suggests that most will not survive one year. However, younger individuals or those without other health problems can live indefinitely on tube feeding as a sole source of nutrition.
How can home health care help with tube feeding?
George has been faced with the decision of moving into a higher level of care or entering hospice care due to his inability to keep up with administering his own medications and feedings. Family members were unable to help him, and he highly valued his independence.
George contacted Sunland Home Care & Medical. He scheduled an assessment, and four one-hour visits each day to manage his tube feeding and medication administration. His daughter is pleased with his choice. It gives her peace of mind to know that her father is being cared for by professionals and will remain in his home.
Sunland Home Care & Medical can:
- Prepare and administer tube feedings.
- Provide the care your family would if they were able.
- Allow you to conserve your energy for more enjoyable tasks.
