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The quality of life was another issue addressed in research of the use of feeding tubes with patients who have dementia (Finucane, 2001).
Robert MCCann, MD reports that the everyday imagery of food and its pleasant addition to life cannot be ignored in the discussion of removing natural nutrition and using a feeding tube.
McCann reminds the medical community that the image of a family gathered around the Thanksgiving table, interacting and nurturing each other through the meal presents an entirely different image than an elderly person suffering from dementia alone in a bed in a nursing home with a tube inserted into their stomach. The imagery of food and its measurable impact on a person's life must be accurately envisioned for the decision to be made according to McCann (Finucane, 2001).
McCann studied Hospice cancer patients who were in the end stage of life. According to his research it is a natural part of dying to lose one's appetite as well as one's thirst.
He posits that to interrupt that natural process is actually to place a burden on the patient who is at the end stages of their life. The participants in this study were alert and cognitively responsible in the final days of life and expressed an desire not to have a tube as their desire not to eat was something they did not feel they were suffering because of.
In a study specifically confined to the attitudes of nursing staff members and patient relatives with regard to the use of feeding tube use the participants indicated they were ambivalent to its use and did not report any improvement in the patent's quality of life when a tube was used (Lebovitz, 2001).
An...
According to Ersek the feeding tube controversy has not been laid to rest because the studies do not indicate with conclusive evidence whether or not they have a place in the care of those at the end stages of life (Ersek, 2003).
As society continues to debate the use of feeding tubes during the end stage of life patients continue to hang in the balance. While feeding tubes can prolong the physical components of life, weight must be given to the quality of life that the patient will have while on the tube. Is a life confined to bed, without a conscious understanding of what is going on around them a life that they would want? It is a question that came before the courts in the Terri Shiavo.
To date studies have not indicated that a feeding tube improves the quality of life, though evidence is found that tubes increase infections. With the advances in medical science increasing the life span consistently it will be important in the future to educate people on the importance of having a living will. This will provide protection at the end of life for the patient who does not want a feeding tube inserted and will relieve the family of having to make the decision.
References
Funicane, Thomas (2001) a Review of the Evidence the American Geriatric Society.
Lebovitz, Lubert, a. Habot (2003) Attitudes of Relatives and Nursing Staff Toward Tube feeding in the Severely Dementia Patients. American Journal of Alzheimer's Disease and Other Dementias.
Ersek, Mary PhD RN (2003) Artificial Nutrition and Hydration. The Journal of Hospice and Palliative Nursing.
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