Feeding Tubes for the Elderly

What Is a Feeding Tube?

A feeding tube is a device that’s used to nourish individuals via a direct route to the stomach. Tubes are used to give people medicine, food, and liquid when they aren’t able to take these substances by mouth. A variety of feeding tube styles exist.

  • Gastrostomy tubes extend about six to 12 inches from the stomach.
  • Jejunostomy tubes are surgically inserted into a person’s small intestine.
  • Nasogastric tubes carry nourishment through the nose and directly into the stomach.
  • Nasojejunal tubes also pass through the nose, but instead of connecting to the stomach, they are connected to the small intestine.

Depending on your specific condition, a doctor may advise you or your loved one to consider having a feeding tube inserted. According to the American Society for Parenteral and Enteral Nutrition, feeding tubes are used in approximately 250,000 hospital stays each year. Around 75% of those feeding tubes are administered to adults, and another 400,000 people use feeding tubes within a home setting.

Who Typically Needs One?

Feeding tubes are used to treat a variety of conditions. While people from infant age through adulthood sometimes require tubes, seniors may be advised to use one for many reasons.

Diseases

Some people have conditions like Parkinson’s disease which make chewing difficult due to the loss of motor control. Cancer can also make taking food by mouth difficult if the person is fatigued or if the cancer is present in the mouth, neck, or another part of the upper body. Sometimes, seniors with dementia are given feeding tubes when they have difficulty eating.

After a Stroke

Neurological conditions, like a stroke, can cause someone to need to use a feeding tube. ALS can also interfere with the body’s ability to chew food. If you’ve already lost lots of weight or are deemed at-risk for losing weight, your doctor may suggest using a feeding tube.

Injury

If an adult experienced trauma to their stomach or abdomen, digesting food normally can be difficult. Feeding tubes can help these seniors receive sustenance without having to pass through injured body parts.

Gastrointestinal Issues

Some seniors experience gastrointestinal problems that create issues in their stomach or bowels. One example is a bowel obstruction. Bowel obstructions typically happen to seniors, and they can occur when part of your intestine gets twisted, affected by a hernia, or even from a tumor.

People can use feeding tubes for different lengths of time. Some people only need one for a few weeks or months while others may use them indefinitely.

What to Expect When Receiving a Feeding Tube

If a doctor determines you need a feeding tube, you will need to undergo a short surgery to have the tube inserted into your body. Fortunately, the surgery is fairly commonplace and only takes around 45 minutes.

You will be advised to not eat anything for several hours before the surgery. On the day of your surgery, you’ll be given a shot to numb any pain as well as several medications, including an antibiotic, a painkiller, and a sedative. The surgeon will then identify the optimal location for your tube within your stomach or intestine and will insert the device.

Your tube may last several years (up to three), although it may need to be replaced sooner than that.

Foods Administered Via a Feeding Tube

Your physician will help you determine which foods are appropriate for your diet. The simplest nutrition source is premade food that’s available for purchase. Brands that manufacture feeding tube formulas include:

  • Nestle (Compleat and Isosource)
  • Real Food Blends
  • Kate Farms
  • Nutren Glytrol

While many prepared meals are on the market, some seniors choose to blend their own foods from home. The reasons people choose to use home-blended foods range from convenience to health reasons:

  • Seniors may feel that eating foods made at home feels better emotionally.
  • People may be less at risk for constipation or diarrhea.
  • It’s easier to manage the amount of sugar and ingredients in food when preparing it at home.
  • Seniors may enjoy and feel better from eating a varied diet

Some limited studies suggest that people who eat food blended at home may help patients gain weight and experience less gastrointestinal problems than people who consume premade tube feeding formulas.

Pros and Cons of Feeding Tubes

As is the case with many medical treatments, feeding tubes offer several advantages while also increasing the likelihood of certain side effects. The choice to utilize a feeding tube is one that should be thoroughly discussed with your healthcare provider to ensure a senior is well-informed of the benefits and risks associated with using one of these devices.

Pros

  • People who use feeding tubes are able to receive the necessary nourishment to keep their bodies going. The food intake process is relatively effortless and may increase your chance of living longer, depending on your overall health.
  • Your health will likely improve due to the increase in nutrition entering your body. This change means you’ll be at a lower risk for bedsores.
  • Some seniors can even administer their own food through the tube. Alternatively, caregivers are able to do so from home. Seniors with feeding tubes don’t need to spend time in the hospital to eat.

Cons

  • Liquid may enter your lungs when you are using a feeding tube. This problem can lead to pneumonia, a serious problem in seniors.
  • The physical aspect of having your body connected to a feeding tube may be a drawback for some seniors.
  • Certain health conditions may be too advanced or severe for feeding tubes to offer an appropriate solution to nutritional needs. You may put your body at risk for complications.

Complications of Feeding Tubes in Elderly

While many people use feeding tubes without issue, there are certain complications that can result from feeding tube use.

Some of the problems that can arise include:

  • Broken or unplugged tubes
  • Leakage from the tube
  • Stoma dermatitis (skin problems around the tube)
  • Diarrhea
  • Constipation
  • Dehydration
  • Perforation (tearing) of the intestines
  • Abdominal infection

When these issues happen, the treatment varies. For a blocked, broken, or unplugged tube, the solution is typically simple: The medical professional will insert a new tube. In other situations, the affected area is treated locally, or the person undergoes another form of treatment.

Report any problems with your tube to your doctor immediately. If it falls out of your body or shows signs of leaking, speak with a physician as soon as possible to prevent further complications. The incision within your stomach may heal over in a matter of hours.

Tips for Safely Using a Feeding Tube

Always follow the advice of your physician, as they can provide guidance on specific ways to best care for your feeding tube.

In general, there are some guidelines for preventing complications while using a tube:

  • Wash and dry hands thoroughly before touching your feeding tube
  • Flush the tube with water before and after administering food or medicine
  • Adjust the rate of food flow if you begin to feel uncomfortable, such as nausea
  • Keep an eye out for signs of infection around the stoma. Infection signs include redness and itchiness.
  • Clamp the tube when not in use
  • Tape your tube in place with medical tape

Cleaning and Flushing Your Feeding Tube

Keeping the tube area sanitary is a must to prevent infection. One way to prevent issues is to keep the feeding tube from being clogged. Flushing the tube multiple times throughout the day is recommended.

Remember to flush your tube:

  • Before the first feeding of the day
  • After the last feeding each day
  • If the device gets clogged in between

Depending on the size and style of your feeding tube, your doctor will advise you how much water to flush the device with. You’ll receive instructions for flushing your tube when you are discharged from the hospital after your surgery. Be sure to follow the physician’s guidelines for managing your device.

Cleaning the area around the stoma is essential to keeping infection at bay. You may have a plastic disc called a skin flange that surrounds the tube and rests against your skin. You’ll need to clean under the skin flange frequently (at least once a day), and you may be advised to rotate your tube multiple times throughout the day after surgery.

Conclusion

Feeding tubes can be beneficial for seniors who need to receive nutrition via a direct method. Like with many other medical treatments, feeding tubes have pros and cons. The complications that may arise from using a tube should be compared to the benefits. It’s important to note that many complications, such as infection, can be prevented through proper maintenance and health regimens. A conversation with your doctor can help you decide if using a feeding tube is right for you or your loved one.

Sources:

  1. Feeding Tube-related Complications and Problems in Patients Receiving Long-term Home Enteral Nutrition, NCBI, www.ncbi.nlm.nih.gov
  2. Tube Feeding: Living With a Feeding Tube, University of Michigan Health, www.uofmhealth.org
  3. Home Enteral Nutrition, Mayo Clinic, www.mayoclinic.org
  4. Information for Patients: Common Life-Sustaining Treatments, Veterans Affairs, www.ethics.va.gov
  5. Complications Associated with Feeding Tube, Stanford Healthcare, stanfordhealthcare.org
  6. Percutaneous Endoscopic Gastrostomy (PEG) Tube Basic Care Guide, Royal Children’s Hospital, www.rch.org.au
  7. Home Blenderized Tube Feeding: A Practical Guide for Clinical Practice. National Center for Biotechnology Information, www.ncbi.nlm.nih.gov

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