I'm under the impression that the tube was inserted at the onset. It would have had to be because she was on a resperator aftr they got her heart going again. I don't know if it was ever removed and put back in later, but if it was, there is a record somewhere.
I know that they don't insert tubes for convienience at care facilities. NEVER. That is a lie. Who ever came up with that one hasn't a clue what they are taking about.
Feeding tubes are only inserted when a person can no longer take food oraly due to medical problems.
Feeding tubes are more of a hassle than spoon feeding someone, there is protocol to follow, sterilization proceedures, not to mention special "food" preperation. Most care facilities operate using health care aids, not a team of nurses who would have to do the feeding tube proceedure.
Most places only have one nurse per ward, some only one nurse for several wards.
When it was time to feed her, caretakers would have attached a syringe to the end of her tube, and pulled out the plunger to see how much fluid came out of her stomach. If there wasn't too much in there already, they'd fill up the syringe with a commercial liquid diet product like Ensure. (A single meal consists of 2 or 3 cans, or you can use regular food that's been liquefied in a blender.) It's also possible that Schiavo received continuous feeding using a 24-hour pumping mechanism, which is used for patients at higher risk for regurgitation and aspiration pneumonia.
http://slate.msn.com/id/2115227/ <-- Link
Doesn't sound like too much of a hassle. My wife is undertaking a special procedure at this very minute, heating some soup and spreading egg salad on some bread.
I haven't found information regarding "tube in" tube out" chronology, most of the search engine hits are current events.
You know, I thought convenience was the reason one of the "care facilities" that my mom stayed at talked me into having a feeding tube installed. She was there for physical therapy after hip replacement surgery. They told me, in smooth, quiet tones, that mom couldn't swallow food anymore. What??? She's sitting there swallowing saliva right in front of us!
While my mom had advanced Alzheimer's and dementia, she was cooperative with the staff. At first, they had her doing cognitive therapy, like putting pegs into a peg board, but said she couldn't handle walking through parallel bars. Meanwhile her weight was dropping. I saw her every day, and I started bringing baby food with me to feed her. No one would watch her swallow! Every day, I would ask the physical therapy department when they were going to work with my mom. One therapist, she didn't work there on a regular basis, committed the sin of sitting my mom down with a tray of soft food. She was so hungry, she polished the tray with her roll.
The regular therapists were outraged. They behaved so unprofessionally, that I got my mom out of there ASAP. The final place she was at was wonderful. It was a small board and care for Alzheimers patients, and it was in a single family home enviroment. As a matter of fact, we started worrying that she was eating too much. We celebrated her birthday, Christmas, Mother's Day, and she got to see her first greatgrandaughter. She may not have known who we were, but she was darn glad to see us.
No, I don't think in my mom's case that it was a matter of convenience. Her nourishment came in a prepackaged bag that hung on an IV stand. No, what they did was hook her up and leave her sit. I didn't see any extrordinary effort on their part regarding the tube. No, they simply tagged her as a USELESS EATER, but they didn't count on me yelling BS. Lol, the therapists started hiding from me :-D
Yep, I got a dog in this fight...
Take that up with Dr. McConnell, and I' wager there are others who would hold as he does.
Use of Feeding Tubes in Advanced Alzheimer's Disease and Dementia Patients-Part I Within the last 4 months the two most prestigious medical research journals, the New England Journal of Medicine and The Journal of the American Medical Association, have published articles questioning the use of tube feeding in people with advanced cases of Alzheimer's disease and dementia. This appears to be a stance favored by many experts in the dementia field. Figures indicate that presently about 36,000 dementia patients have feeding tubes.The research in these articles involved a review of the medical literature and indicated that there was no evidence that feeding tubes helped most patients. Additionally, they found that this procedure could be harmful in a number of cases.
The iatrogenic effects include infection, diarrhea, and bloating. Another common occurrence is that the patient who feels uncomfortable with a feeding tube will pull it out. This may in turn result in the patient being placed under restraint.
The NY Times (Jan. 20, 2000) quotes Dr. Stephen McConnell, a spokesperson for the Alzheimer's Association which was not a participant in these studies: "This is a position we actually took years ago, that it is ethically permissible to withdraw or withhold hydration and nutrition from somebody in advanced stages. Now there's some scientific evidence that tube feeding doesn't do what everybody thinks, prolong life or make people more comfortable."
Dr. McConnell is further quoted as saying that the tube is often used for the convenience of nursing home staff. "The problem in homes is that it is costs more to pay a person to feed a patient that it does to just jam in a tube and walk away." This statement arises because of the amount of time that the nursing home staff member would have to spend trying to plead and cajole such a resident into taking even a slight amount of nutrition. When you have several such residents in one wing of the home the staff members could be tied up for many hours per day trying to feed the residents.
Then there is the question of insurance payment. Insurers pay for a feeding tube, but do not pay to have a staff member feed a resident. The former is a reimbursable medical procedure and the latter is an activity of daily living, not separately reimbursable because it involves a functional activity.
Dr. Muriel Gillick wrote the article in the New England Journal of Medicine. Dr. Gillick is associate professor of medicine at Harvard and staff doctor at the Hebrew Rehabilitation Center for the Aged in Boston. She compared tube fed patients with non tube fed patients and found that they do not live longer, nor do they show signs of being better nourished than the non tube fed patients. She also reported that the tube fed patients have lung problems from choking on their own saliva and stomach secretions. Dr. Gillick indicated that elderly people with advanced dementia who have eating problems die within six months, whether they have a feeding tube or do not have a feeding tube. It is Dr. Gillick's feeling that loss of appetite in Alzheimer's disease is a sign of the final stage in a fatal disease. Such terminally ill people "not given food or water did not suffer hunger or thirst and could be kept comfortable with ice chips and swabs to moisten the mouth and lips. Dehydration leads them to lapse into comas and die peacefully..." (NY Times, Jan. 20, 2000)
Harold Rubin, MS, ABD, CRC, Guest Lecturer
January 22, 2000
http://www.therubins.com/geninfo/feedtubes.htm <-- Link
Other readers of this post are encouraged to visit that link. Here are later paragraphs.
Our mother died ten days before they were to remove this tube. She had lived along and fulfilling life. We had researched the effects of dehydration and starvation and were comfortable with the researchers who felt it would not be painful.The situation with our mother is different than the terminally ill dementia or cancer case. She was in neither of these cohort groups.