Feeding Tube for Advanced Alzheimer's

[jbettin]

(Apologies in advance if this has been asked already – I searched the forums, but didn’t see this question addressed.)

My mother suffers from Alzheimer’s disease, and her condition is continuing to worsen. The progression of this disease is such that at some point in the future, she will most likely no longer be able to swallow. After researching the topic, I understand that in general, it is not morally permissible to refuse to provide a feeding tube. However, the National Catholic Bioethics Center also says the following:

“Patients who suffer from dementia often do not benefit from the provision of food and water by artificial means, but each case must be judged on its own merits.”

Can someone tell me what kinds of questions I need to ask her doctor to determine if she would benefit from a feeding tube? I know that if she were in her right mind, she would strenuously object to anything that would artificially prolong her life, including a feeding tube. However, it’s obviously wrong to cause her to die of starvation. At what point in a case like this is the patient considered to have begun the death process?

If anyone has been through this with a family member, I’d be grateful for any advice you can give me!

 

[maryjk]

My mom didn’t have Alzheimer’s, but we had the option of a feeding tube. She couldn’t eat or drink. She couldn’t swallow, at all.

What questions to ask?
I asked what would happen if we didn’t have the tube put in. And what difference it would make if we put in the tube.

I asked how the tube was put in. How we would take care of the site. How she would be fed. I asked about pain levels. If we could give meds through the tube.

And since, at that point my Mom was coherent, I asked what she thought.

We ended up putting one in.

 

[NFrancis]

2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.

Here are several threads that seem relevant to your situation:
forums.catholic-questions.org/showthread.php?t=731151&highlight=feeding+tube
forums.catholic-questions.org/showthread.php?t=760435&highlight=feeding+tube
forums.catholic-questions.org/showthread.php?t=670361&highlight=feeding+tube
forums.catholic-questions.org/showthread.php?t=696477&highlight=feeding+tube
forums.catholic-questions.org/showthread.php?t=705025&highlight=feeding+tube
forums.catholic-questions.org/showthread.php?t=712708&highlight=feeding+tube
forums.catholic-questions.org/showthread.php?t=713431&highlight=feeding+tube

 

[1ke]

Can someone tell me what kinds of questions I need to ask her doctor to determine if she would benefit from a feeding tube?

I think it best that you contact the Center and talk to an ethicist.

 

[jbettin]

Thanks so much for the information, everyone! I’ll do some reading on this and talk it over with my brother.

 

[Listener]

Here are a few more thoughts to be considered. I think this can be as much a medical question as a moral question. I think it depends on where a person is in the dying process. When people are close to death, I don’t believe that their bodies are capable of processing much food. If they are still eating on their own, it is normal for them to take a bite or two and push the rest away.

The other thing to consider is whether or not a person with Alzheimer’s could tolerate a feeding tube. They might hate it and try to pull it out. If you had to sedate them enough to stop them from pulling the tube out, they might die quicker from all of the drugs.

I think that each case is different, and you need to use your best judgment.

 

[mikethom]

If you try to use feeding tube, she will never be able to leave it. I suggest you to rather teach her to swallow the food. It will be beneficial for her.

 

[Falco]

You do NOT want to watch your mother die of hunger and thirst. This happened to my mother - she had cancer of the jawbone, and the radiation treatment was too widespread and burned the inside of her mouth, and her tongue. She could not eat or drink, and had to be given nourishment through a nasogastric tube.

The doctor advised that we were keeping her alive artificially, and because of the horrendous pain she was in ( she was in a light coma most of the time), it would be kinder to let her die naturally. OK, so they cut off the food and water, and the horror began. I begged to have the water continued, but they said it would prolong the horror for a couple of weeks, whereas without water she would go in a couple of days. Six days later, she died. I can NEVER get the horror of it out of my head. Eleven years later I still scream at times at the memory of what I had to allow to happen to my mother. It is an academic exercise to the doctors, they are in and out of the room in minutes, but you sit there for days and days and watch your own flesh and blood die of hunger and thirst. It is too much for anyone to bear.

Someone being fed by tube is ill enough that they will die in their own good time.

 

[awke]

Thanks so much for the information, everyone! I’ll do some reading on this and talk it over with my brother.

Be sure to talk it over with God.

 

[maryjk]

Falco:

awke:
Old thread, guys.

Chances are, the OP has already decided what to do.