Tube-Feeding in Dementia Nursing Home Residents Drops Dramatically
BOSTON — The proportion of nursing home residents with advanced dementia and eating dependency who received feeding tubes decreased by approximately 50% between 2000 and 2014 according to a new study published in the Journal of the American Medical Association (JAMA).
Researchers from the Harvard Medical School affiliated Hebrew SeniorLife Institute for Aging Research (IFAR), Brown University’s Center for Gerontology and Health Care Research and University of Washington’s Cambia Palliative Care Center of Excellence conducted the study.
Investigators reviewed data on more than 71,000 advanced dementia residents in nursing homes across the U.S. From 2000 – 2014, researchers found that the proportion of residents receiving feeding tubes declined from 11.7% in 2000 to 5.7% in 2014. Among white patients, insertion rates declined from 8.6 to 3.1% while rates in black patients declined from 37.6-17.5%. For both cohorts, the proportion of residents with advanced dementia and eating dependency who received feeding tubes decreased by approximately 50% between 2000 and 2014.
According to Susan L. Mitchell MD, MPH, lead author of the study and Director of Palliative Care Research at IFAR, “This decline parallels the emergence of research, expert opinion, and recommendations by national organizations discouraging this practice.” In the future, to ensure that expert recommendations are disseminated and racial disparities are reduced, researchers argue that fiscal and regulatory policies are needed to discourage tube-feeding and promote a palliative approach to feeding problems for people with dementia.
This study was supported by NIH-NIA P01AG02729. Dr. Mitchell is supported by NIH-NIA K24AG033640.
About Institute for Aging Research
Scientists at the Institute for Aging Research seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity and productivity into advanced age. The Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment and cure of disease; advance the standard of care for older people; and inform public decision-making. The Aging Brain Center within IFAR studies cognitive aging and conditions affecting brain health.
About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching and redefining the possibilities of aging. Based in Boston, the non-profit, non-sectarian organization has provided communities and health care for seniors, research into aging, and education for geriatric care providers since 1903. For more information about Hebrew SeniorLife, visit https://www.hebrewseniorlife.org, follow us on Twitter @H_SeniorLife, like us on Facebook or read our blog.