Twenty years ago, using feeding tubes for those with severe advanced dementia was common. But since then, the number of nursing homes using that method has steadily declined, notes a study published in the Journal of the American Medical Association (JAMA).
The study, based on MDS data from 2000-2014, showed a steady drop in the number of feeding tube insertions from 11.7 percent in 2000 to just 5.7 percent in 2014.
The massive reduction is partly culture change and partly research, says Susan Mitchell, MD, MPH, senior scientist at Hebrew SeniorLife Institute for Aging Research and lead author on the study. “This decline parallels the emergence of research, expert opinion, and recommendations by national organizations discouraging this practice.”
Other keys to the trend have been educating families that eating and swallowing problems are natural parts of the last stages of dementia and that using a feeding tube isn’t necessarily good for quality of life.
Yet, vast fluctuations in tube feeding trends remain, both regionally and racially. While the use of tube feeding has dropped across the board, black nursing home residents are five times as likely to receive a feeding tube than white residents. In addition, nursing homes in the South are more likely to use them than their counterpart facilities in other regions, especially if they're for-profit, the study revealed.
In the future, fiscal and regulatory policies may be needed to ensure that expert recommendations for people with advanced dementia are communicated and to reduce racial and regional disparities, the study authors write.
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