Feeding Tubes for the Elderly
Being told that you, or perhaps someone you are a CDPAP caregiver for, are in need of a feeding tube, can be a very surreal experience and can require a lot of adjustment in your daily life. The information collected here will help you adjust and make informed decisions where possible.
Let’s start out with a straightforward definition of what exactly a feeding tube is.
What Is A Feeding Tube?
In its most simple sense, a feeding tube is a device used to feed those who are unable or even unwilling to nourish themselves by mouth. They are used in an incredibly wide variety of situations and are responsible for saving countless lives.
There are multiple types of feeding tubes that may be encountered, used for a number of reasons. Those who experience difficulty swallowing, disordered eating, altered consciousness, and many other medical reasons may be given one to make it easier for them to take in calories.
There are also temporary uses. Often these are for reasons relating to sickness requiring hospitalization, like COVID-19, or due to hunger strikes where feeding is court-ordered. These will usually see feeding tubes that are only installed for a few weeks.
Types Of Feeding Tubes
There are two different types of feeding tubes that are used, and they are used based on how long they’re going to be needed. There are tubes that are meant for short-term use and those that are intended to be used on a more permanent basis.
Temporary Feeding Tubes
For nearly all temporary use, short-term feeding tubes are routed into the stomach by one of two temporary tubes.
The nasogastric tube is routed to the stomach through the nose and must be replaced after approximately 4 to 6 weeks. The orogastric tube gets to the stomach through the mouth, and can only last for about 2 weeks.
Once the tube is inserted and routed down the throat, it will then rest in the stomach or intestine. There they will remain until they are either removed or replaced with one of the long-term feeding tubes.
Permanent Feeding Tubes
Long-term feeding tubes are used for applications of 2-4 months or longer. They have a placement similar to short-term tubes, in that they can rest in the opening to the stomach, or in the middle of the small intestine.
Gastric tubes allow for very direct access to the stomach through a port in the abdomen. The gastric tube allows the patient to bypass the mouth and throat entirely. This is frequently a much more versatile option, since it can accept most food, drink, and even prescription medication to be easily taken.
Jejunotomy tubes are placed in an abdominal incision that allows easy access to the middle portion of the small intestine. While it is smaller and more physically innocuous than the gastric tube, it is thinner and can only be used for thin liquids and finely ground or dissolved medication.
Why Would Someone Need A Feeding Tube?
A large number of cancers can make eating unpleasant, painful, or impossible. Cancers of the mouth and throat may present physical barriers for patients to chew or swallow.
Some treatments may also affect the patient’s ability or will to eat also. Chemotherapy is known to make even some of the patient’s favorite foods taste bad while undergoing treatment.
Traumatic Brain Injury
After some brain trauma, there may be lasting effects on both motor skills as well as cognition. With both of these challenges to overcome, those healing from traumatic brain injuries may find that a feeding tube is easier than full meals. It is also a low-stress option that can be easier to be accomplished unassisted by the patient.
Strokes can create unpredictable effects in those surviving them. This can lead to incredible difficulty in a successful mealtime, both in preparation and feeding themselves. Using a feeding tube can make this process easier during recovery.
Those living with Parkinson’s or other similar neurological conditions may find the feeding tube easier than eating. With the tremors and muscular stress involved in eating, a feeding tube can be a far quicker and easier way to eat.
Patients with dementia or similar conditions can be challenging during mealtime. Sometimes they can present aggression, or refuse to eat, or any number of situations. In cases like these, a feeding tube can cut the stress level at mealtime, and ensure the patient gets their needed nutrition.
In the case of patients that have been placed on a ventilator, like victims of the ongoing pandemic, feeding tubes are a necessity. They are the only way the patients can breathe and take in calories.
Pros Of A Feeding Tube
There are a ton of benefits to using or having a feeding tube, not the least of which is being able to give your body the calories it needs. Here are more benefits you can expect.
● Provides Nutrition To Those Who Can’t Or Won’t Eat
The most valuable benefit is also the most obvious one. Feeding tubes help keep people alive and well that aren’t otherwise able to eat or swallow safely.
● Relief Of Gas, Bloating, And Nausea
For those that tend to suffer from gas, bloating, nausea, or other digestive anomalies, taking nutrients through a feeding tube can help to reduce some of those effects. A large part of this is due to far less air being taken in, and smaller portions being consumed.
● Can Help Prevent Aspiration Of Food Particles
Feeding tubes are a great way to help avoid accidentally inhaling food particles. Those with breathing issues or spasms may lower their risk of respiratory infection from inhaled food particles.
Cons Of A Feeding Tube
Even though a feeding tube is an ideal way for millions of people to obtain their needed nutrition, they do still come with some risks. Here are a few of the most common downsides to having a feeding tube.
● Potential For Infection
No matter how well it is cared for, and how often it is checked, a feeding tube is still entering your body through a hole that wasn’t there before. This will heal to some extent but it will always be a wound, to some extent.
While infections are incredibly rare, they are known to happen. With the nature of the feeding tube and its entrance into the body, however, even a minor infection can become dangerous quickly.
Even with the most well-placed port and the best, cleanest feeding process, leaks are going to happen. This isn’t usually a huge deal, but they can be inconvenient and messy.
● Doesn't Improve One’s Life
No matter how you look at it, a feeding tube is essentially the best possible workaround for not being able to take food and drink by mouth. No matter how good it gets, it won’t be able to provide any benefits over taking nutrition and medication by mouth.
This is another con that stems from a feeding tube basically being a constant open wound. Even though it may not be painful, or be causing any obvious discomfort, it just isn’t comfortable to have. You will feel it there, and it will occasionally snag on articles of clothing.
Alternative To Feeding Tube
All other things being equal, the only reasonable substitute for using a feeding tube is going to be hand feeding. If hand-feeding is applicable to the patient’s situation and needs, then it can be attempted.
Hand-feeding will involve measuring out the appropriate portions of food, and then pureeing them to a sufficient degree. Once the food is processed into the consistency the patient needs, it can be slowly spoon-fed to them.
Hand-feeding will often only be applicable for patients that are capable of swallowing. The patient also must be able to breathe on their own and have an intact esophagus.