#1
Thousands of elderly people are being forced to have tubes fitted so they can be artificially fed if they want to be admitted to a care home, a major report warns today.

There is no evidence that tube feeding prolongs life, and it deprives patients of the pleasure and social contact involved in normal eating and drinking, says a Royal College of Physicians working group which recommends that artificial nutrition should only be used as a last resort.

The report found that many care homes across the country are making it a condition of residence that people, often in the advanced stages of dementia, have a tube fitted into their abdomen.

"This is an invasive procedure with a risk, so it should not be undertaken lightly," said Dr Rodney Burnham, chair of the working group. "One of the concerns we had was that we felt in many places there were cases where this was done without proper thought.

"This is a widespread problem. Many care homes say they will not take a patient until they have had a gastrostomy. There is no reason for them to do that. They should have nursing support."

With time and care, elderly people with swallowing difficulties can be helped to eat and drink normally, says the report.

Produced with the help of the British Society of Gastroenterology, the report aims to guide healthcare professionals, who are sometimes at odds over the merits and ethics of the situation. There is a misguided belief, it says, that tube feeding keeps patients alive longer. But the evidence does not support this.

A recent national confidential inquiry into patient outcomes and death (NCEPOD) investigation found 19% of those undergoing the procedure had it fitted inappropriately. "They described it as futile," said Burnham. Almost half of those who died (43%) did so within a week.

While a nasal tube is safer than a device fitted in the abdomen, a so-called PEG, the best option for patients is normal feeding wherever possible. "'Nil by mouth' should be a last resort," says the report.

It calls for agreement between the patient, relatives and healthcare professionals about the aims of artificial feeding. "Such decisions should never be based on the convenience of staff or carers. Nor should artificial feeding ever be required as a criterion for admission to any institution providing care," says the college.

All trusts and care homes should ensure there are enough staff to help those with difficulties take longer to eat, especially at meal times. "People in the later stages of dementia have complex end-of-life needs and it is vital that the use of artificial nutrition or hydration not be used in place of good quality care tailored to their specific needs," said Neil Hunt, chief executive of the Alzheimer's Society, which believes that "the quality of life should be considered a priority over length of life in the later stages of dementia".

The numbers of people in the community fitted with tubes for artificial feeding has risen steeply. One survey showed a growth of 11.6% between 2006 and 2007.

A Department of Health spokesperson said: "The use of intrusive interventions, such as tube feeding, is a clinical decision and should only be used when necessary, based on the circumstances of the person concerned, and with their or their representative's agreement. We would expect services to allow maximum choice and control wherever possible and to respect people's dignity and human rights right up to the end of life."

http://www.guardian.co.uk/society/2010/jan/06/care-homes-elderly-feeding-tubes
This is the first I've heard about this. It sounds too hideous to be true.
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#2
If you have dementia that "requires" you to have a tube, how much social contact are you really missing?
#3
Everyone knows old people don't have feelings. That's why it's OK to dump them in a care home and forget about them until the reading of the will.
/sarcasm
#4
We've got to give the elderly something I guess, and free surgery is better than nothing.

Even if it is unecessary.
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#8
I can see the ethical issues here...

But I can also see the incredibly high demand, and subsequently low supply of competent nursing staff these days.

OK for everyone? No. OK for people who don't even know who they are? I'd say so.
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#9
Quote by captaincrunk
That's why we live in the US, where we decide our own healthcare!

Wait...

And where the poor are denied care because they can't afford insurance. Then die
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#11
sounds like the matrix


its happening :s
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#12
that is ****ing disgusting! so now we dont feed the elderly like humans, we just plug them into a machine and leave them to it! what the actual **** is happening to this world
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#13
Quote by Brick23
And where the poor are denied care because they can't afford insurance. Then die


And where the rich a denied care because they had an ingrown toenail at age 11 that they failed to mention on their policy application...

We get it, US healthcare sucks. Cry More.
This water's dark and coldGod's not where you hopedThis moment come and goneIt's time we all moved on
#14
Quote by captaincrunk
That's why we live in the US, where we decide our own healthcare!

Wait...

The article didn't specify whether this happened in public or private care homes, or both.
Besides it's irrelevant, the Brits can decide their healthcare just as much as you guys can. In fact, they have more choice.
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#15
Quote by Ur all $h1t
The article didn't specify whether this happened in public or private care homes, or both.
Besides it's irrelevant, the Brits can decide their healthcare just as much as you guys can. In fact, they have more choice.

Sarcasm detector, rent one until yours is fixed guys. Also, there is a healthcare debate thread.
#17
This is great news for Jackal58, can I tell him?
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#18
Quote by br33dlove
If you have dementia that "requires" you to have a tube, how much social contact are you really missing?

This.

Though honestly, if I ever get to that point, I hope they just off me.
#19
Assuming this takes place in the UK, you guys seem to be getting progressively more and more totalitarian. It's just little things like having your internet shut off if you've been found to download stuff and other hodgepodge things such as that.
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#20
Quote by Weeping_Demon7
Assuming this takes place in the UK, you guys seem to be getting progressively more and more totalitarian. It's just little things like having your internet shut off if you've been found to download stuff and other hodgepodge things such as that.

In what way is this an example of totalitarianism or a progression towards that?
"Why should we subsidise intellectual curiosity?"
-Ronald Reagan

"Knowledge is in every country the surest basis of public happiness."
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#21
I think at about 60 we should send old people into battle. That way they aren't sitting around making everyone depressed.

Plus they get to die as heroes.
#22
Quote by Ur all $h1t
In what way is this an example of totalitarianism or a progression towards that?

The UK, to me, in my opinion, not to spark a fight, seems to becoming more government controlled.

Totalitarianism wasn't the right word.
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#23
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This is great news for Jackal58, can I tell him?

No. Let's surprise him.
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#24
Quote by Weeping_Demon7
The UK, to me, in my opinion, not to spark a fight, seems to becoming more government controlled.

Totalitarianism wasn't the right word.

I mean this story here. In what way does this show a progression towards authoritarianism?
"Why should we subsidise intellectual curiosity?"
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"Knowledge is in every country the surest basis of public happiness."
-George Washington
#25
Quote by Jackal58
No. Let's surprise him.

Blog Of Awesome UGers.
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Which is annoying, cos I'm a girl and I like cock.

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Being an idiot should be illegal too.
#26
Quote by Ur all $h1t
I mean this story here. In what way does this show a progression towards authoritarianism?

Is this not government mandated?
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#27
Quote by Weeping_Demon7
Is this not government mandated?


As I understand, it's decided by each individual care home.
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#28
Quote by Weeping_Demon7
Is this not government mandated?

the article doesn't say that it is, certianly not from my reading of it. Not all care homes in the UK are publicly funded, there are private ones just as there are in the USA. People in the UK have just as much choice (more in fact) than people in the USA do.
The government statement on it is: "The use of intrusive interventions, such as tube feeding, is a clinical decision and should only be used when necessary, based on the circumstances of the person concerned, and with their or their representative's agreement. We would expect services to allow maximum choice and control wherever possible and to respect people's dignity and human rights right up to the end of life."

Even if all government care homes mandated this (which they certianly do not) one can easily chose a private one, same as in the USA.
"Why should we subsidise intellectual curiosity?"
-Ronald Reagan

"Knowledge is in every country the surest basis of public happiness."
-George Washington
#30
Quote by Ur all $h1t
the article doesn't say that it is, certianly not from my reading of it. Not all care homes in the UK are publicly funded, there are private ones just as there are in the USA. People in the UK have just as much choice (more in fact) than people in the USA do.
The government statement on it is: "The use of intrusive interventions, such as tube feeding, is a clinical decision and should only be used when necessary, based on the circumstances of the person concerned, and with their or their representative's agreement. We would expect services to allow maximum choice and control wherever possible and to respect people's dignity and human rights right up to the end of life."

Even if all government care homes mandated this (which they certianly do not) one can easily chose a private one, same as in the USA.

Then that is my absolute mistake. I sounded like an ignorant, Britain hating prick. But those where not my intentions. I love the UK!
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