Hand-fed dementia patients see 40% lower risk of pneumonia than those who are tube-fed

Medical Xpress / The University of Hong Kong / Journal of the American Medical Directors Association ^ | Oct. 13, 2022 | Jacqueline K. Yuen et al

[ConservativeMind]

A collaboration study has found that advanced dementia patients with feeding problems initiated on careful hand feeding had a risk of pneumonia 40% lower than those on nasogastric tube feeding.

Patients with advanced dementia with feeding problems such as poor oral intake and dysphagia are often initiated on tube feeding. Feeding tubes are inserted due to the perceived benefits of reducing the risk of aspiration pneumonia and improving survival. However, this has not been shown in previous observational studies conducted overseas. In recent years, some geriatric wards in Hong Kong have begun to offer the option of careful hand feeding as an alternative to tube feeding to promote comfort and quality of life in end-of-life patients with feeding problems.

The research team conducted the first study in Hong Kong of hospitalized patients with advanced dementia with feeding problems to compare the risk of pneumonia and death between those initiated on careful hand feeding versus nasogastric tube feeding.

The retrospective cohort study identified 764 patients with advanced dementia considered for tube feeding due to feeding problems. The findings showed that patients initiated on careful hand feeding had a risk of pneumonia 40% lower than those on nasogastric tube feeding.

There was no significant difference in one-year survival between the nasogastric tube feeding and careful hand feeding groups, with a median survival of 125 and 145 days respectively.

This study provides evidence that nasogastric tube feeding does not confer survival benefits compared with careful hand feeding in patients with advanced dementia. Moreover, nasogastric tube feeding is associated with an increased risk of pneumonia compared with careful hand feeding in this patient population. Postulated mechanisms for increased aspiration risk with nasogastric tube feeding include impairment of the lower esophageal sphincter, desensitization of the pharyngoglottal reflex, and reflux of gastric contents into the pharynx.

[ConservativeMind]

It seems hospitals know how to handle pneumonia, as getting it didn’t greatly affect lifespan, but it obviously would affect patients’ quality of life.

[ConservativeMind]

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[EvilCapitalist]

Is Joe hand fed?

[humblegunner]

What percentage of demntia patients have been disciples of Qanon?
I’d guess 79%.
At least.

Leading cause of dementia for sure.

[lee martell]

Funny you should ask that question.
You’re probably familiar with a well known campaign photo showing Joe Biden and his Bride: Dr. Jill onstage in an outside setting. Both are wearing jackets. Joe is seen (playfully?) nibbling on Jill’s fingertips as she makes a sweeping gesture.
Members of the audience stand behind the stage with slighly puzzled looks on their faces.

[EvilCapitalist]

Yup. I’m familiar with the picture.

[Karliner]

So this means Biden will probably beat pneumonia?

[GrannyAnn]

If I have dementia and need to be either hand fed or tube fed, please, let me die of the pneumonia!

[dangus]

UNBELIEVABLE!!!

Folks, think what nasogastric feeding would have to do with getting pneumonia. They’re either jamming the tube so hard that the lungs are getting blood in them, or the nasogastric tubes are letting food into the lungs. Either way, what terrible suffering from what apparently was merely presumed to be a safe feeding practice!