Feeding tubes for older people with advanced dementia living in the community in Israel

Background: Feeding tubes to address eating problems of older people with advanced dementia (OPAD) has been studied primarily in nursing homes. Objectives: To examine the prevalence of feeding tube use among OPAD living in the community; to evaluate the characteristics, quality of care, and the burden on caregivers. Methods: A cross-sectional survey of 117 caregivers of OPAD living in the community. Results: Of 117 patients, 26% had feeding tubes. Compared to nonusers, feeding tube users had more use of restraints, greater problems with swallowing, more emergency room visits, and were more likely to have a legal guardian. In addition, caregivers of feeding tube users were older and reported very heavy burden of care. Half of the caregivers reported that the medical team consulted them before insertion of the feeding tube. Conclusion: Feeding tube use in OPAD in the community is associated with negative outcomes and increased caregiver burden.