Tube Feeding & Iv Hydration In Late Stage Alzheimer’s Disease

Tube feeding and IV hydration are issues your family may face as your loved one enters the late stage of Alzheimer's disease.

Alzheimer's patients and those with severe dementia may forget how to eat, refuse to eat, be unable to swallow, or unable to use the reflex that allows them to swallow. Your loved one's health care professionals may suggest tube feeding. Most commonly, the procedure involves placing a PEG (percutaneous endoscopic gastrostomy) tube through an incision in the stomach.

There are some things to consider before deciding to tube feed. Feeding tubes are invasive and could lead to infection. In some cases patients need to be physically restrained to prevent them from pulling the tube out. But some families may be afraid to refuse tube feeding– fearing that means they are giving up or neglecting their loved one. However, as difficult as this is, caregivers need to realize that Alzheimer's is a terminal disease and that loved ones can be made to feel comfortable without having a feeding tube. It may be preferable for your loved one to avoid the stress and discomfort a feeding tube may cause. Often, when a person is close to death, their gastrointestinal system shuts down, and a feeding tube can cause considerable suffering.

Another option to the feeding tube is for you to help hand-feed your loved one. If your loved one is in a skilled nursing facility or hospital, the staff may not be able to devote the time necessary to do this. It can take a long time to feed someone who has trouble eating. If you try this, use thick, soft, flavorful foods which can be spooned into the mouth. Encourage gentle coughs after each swallow to prevent choking.

If your loved one has become dehydrated, he or she may need to have IV fluids administered. This will provide fluid temporarily, but won't provide enough nutrition needed to live. Using the IV hydration can give your loved one a few extra weeks to live, but may be hardship for them. Lack of hydration is a normal part of dying and is not painful. It actually allows a person a more comfortable death by lessening the awareness of discomfort over a period of a few days.

If your family decides to use tube feeding and IV hydration, at some point you will need to decide when these treatments should be stopped. When you are dealing with this sort of end-of-life care issues, talk to your doctor about your concerns. Ask about the physical risks and discomforts. Find out if the treatment will help and is it providing the best quality of life. What can be done to ease your loved one's pain? And discuss if this may be the best time to enter your loved one into hospice care. Hopefully, your loved one prepared advance directives so you will know his or her wishes. If not, try to honor what you believe your loved one would like. Consider his or her values and strive to maintain comfort and dignity.

Resources: Alzheimer's Association, American Academy of Family Physicians