Feeding Tubes for the Elderly: Exploring the Pros and Cons of Nutritional Intervention

Living with a feeding tube can sometimes be difficult to navigate, especially if you’re an elderly person who’s interested in an assisted living community. 

Sometimes the need for a feeding tube is unavoidable, and unfortunately, many senior communities are not equipped to take in residents that require tube feeding. But if a feeding tube might be helpful and isn’t truly necessary, some senior communities are happy to accommodate the feeding needs of residents.

Here we will explore the pros and cons of feeding tubes, why they might be necessary, and how to navigate senior communities while living with specific dietary needs.

Table of Contents

• Types of Feeding Tubes for the Elderly
• 5 Reasons Why an Elderly Person May Benefit From a Feeding Tube
• Feeding Tubes for the Elderly: Pros and Cons
• Senior Services of America: Helping Maintain Quality of Life for Elderly Adults

Types of Feeding Tubes for the Elderly

Having an elderly loved one on a feeding tube can be an overwhelming thing to navigate, especially when they live in an assisted care facility.

Feeding tubes can be nasal or abdominal, supplying nutrients to different parts of the digestive system. They may be necessary for many reasons, including:

• After surgery or severe trauma
• Neurological disorders
• Significant weight loss
• Cancer
• Bowel conditions
• Difficulty swallowing
• Stroke

Depending on the reason, feeding tubes are identified as surgical or nonsurgical. 

Non-Surgically Inserted Feeding Tubes

Non-surgical feeding tubes are temporary and often used short-term while a person heals or strengthens their ability to eat independently. They are not meant to be used for more than a couple of weeks to decrease the chance of severe irritation and injury to the tissues of the nose, esophagus, and throat. 

They are inserted through the nose or mouth, and depending on where the nutrition, fluid, or medications must go, they typically end in the stomach or small intestine.

Non-surgically inserted feeding tubes include:

• Nasogastric (NG) tube – Inserted through the nose and ends in the stomach
• Orogastric (OG) tube – Inserted through the mouth and ends in the stomach
• Nasoduodenal tube – Inserted through the nose to reach the duodenum, which is the first part of the small intestine
• Nasojejunal – Inserted through the nose to reach the jejunum, which is the second part of the small intestine

Surgically Inserted Feeding Tubes

Surgically inserted feeding tubes are often permanent and are inserted through the abdominal wall. Although intended for long-term use, surgical feeding tubes can be replaced if the patient regains the ability to eat and drink on their own. These tubes can also end in the stomach or small intestines depending on the need.

Surgically inserted feeding tubes include:

• Percutaneous endoscopic gastrostomy (PEG) – Inserted through the abdominal wall into the stomach

5 Reasons Why an Elderly Person May Require a Feeding Tube

#1: Dysphagia 

People with dysphagia have difficulty swallowing. This can occur at any age, but more often affects the elderly. 

Some people with dysphagia have difficulty swallowing foods, while others also struggle to swallow liquids and saliva, making it difficult to take in enough calories to properly nourish the body. 

Dysphagia can develop from:

• Esophageal spasms
• Narrowing and weak muscles
• Tumors
• Radiation that has scarred or inflamed esophageal tissue
• Scarring and hardening of esophageal tissue due to scleroderma
• Tissue damage from stomach acid in individuals with GERD

#2: Gastrointestinal Issues 

A common health challenge that many elderly people face is a decline in digestive health. Nearly 40% of older adults have one or more age-related digestive symptoms that can lead to larger issues, creating problems in the stomach or bowels. 

Most common in seniors are bowel obstructions which occur when part of the intestine gets twisted from a hernia or a tumor.

Other common gastrointestinal issues include:

• Constipation
• Dehydration
• GERD
• Polyps
• Ulcers from NSAIDs
• Diverticulitis

#3: Injury

If an elderly person has experienced trauma to their stomach or abdomen, it may become difficult to digest food.

Trauma can be caused by many things, like surgery, blunt trauma from an accident or fall, or internal trauma from medication use.

To avoid pain and further damage to the injured part of the abdomen or stomach, a feeding tube can help seniors receive sustenance and calories without having to pass through the injury.

#4: Dementia

Seniors with dementia often have trouble connecting with their daily life. Because the symptoms of dementia affect memory, elderly dementia patients sometimes have trouble recognizing food and being willing to eat it.

First, they work hard to remember what food they are about to eat. Then, they must decide to chew and swallow it. If they suffer from dysphagia, this interferes with the reflex action that enables swallowing, putting these elderly patients at risk for aspiration and potentially dangerous lung infections.

Dementia patients may also become malnourished, dehydrated, and underweight.

A percutaneous feeding tube (PEG) is a flexible plastic tube that can be placed through the abdominal wall into the stomach with an endoscope to provide food, water, and medication directly to a dementia patient’s stomach.

#5: Additional Reasons 

There are many other conditions and reasons an elderly person might require a feeding tube.

• Parkinson’s disease makes chewing difficult due to the loss of motor control.
• Cancer can make eating difficult due to fatigue or if the cancer is present in the mouth, neck, esophagus, or upper body.
• Neurological conditions like stroke or multiple sclerosis can affect a person’s feeding.
• ALS can interfere with the ability to chew.
• Loss of appetite can develop due to:
  • Thyroid disease
  • Cancer
  • Alzheimer’s disease
  • Parkinson’s disease
  • Gum disease
  • Salivary gland issues 

Having a loved one that requires a feeding tube can be scary and could cause concern about their care, especially in an assisted living facility. Be sure to ask the community about their policies and procedures in managing feeding tube care. 

Feeding Tubes for the Elderly: Pros and Cons

Pros

When used under the right circumstances and in an environment of loving caretakers, a person’s quality of life can drastically improve with a feeding tube. 

For the elderly, feeding tubes can:

• Relieve gas, bloating, diarrhea, and nausea
• Assist with digestion of foods, liquids, and medications
• Ensure caloric intake
• Ensure food and liquids end up where they should to avoid aspiration
• Easily be removed by a healthcare provider if necessary 

Provides Nourishment

As you age, the necessary number of calories declines as basic body processes begin to require less energy. However, nutrient needs remain the same. Using feeding tubes for the elderly ensures proper nourishment is being received to sustain their health.

Although caloric needs vary depending on age and activity level, most older adults require about 1,600 calories to meet their energy needs. This number slightly decreases to about 1,200 calories for the elderly using feeding tubes.

May Provide Independence

Although assisted living facilities have staff on hand to help with tube feedings, some seniors can self-administer their food through the tube. This allows for a level of independence, despite the need for a feeding tube. 

Cons

Again, depending on the circumstances, feeding tubes in the elderly might have negative effects. 

One study showed that the mortality rate for elderly patients using a PEG tube for one year is estimated at around 50-60%. Even more, nearly 70% of patients who survive beyond that one year show no improvement in function or nutritional status.

Limits Senior Community Options

Not all senior communities will take elderly residents with a feeding tube. Since many do not offer this level of care, this would be a critical topic to cover and consider while researching a senior community.

Generally, feeding tube care is more appropriate for a skilled nursing setting, but some communities are equipped with the staff to help care for residents who require one.

Can Be Expensive

Feeding tubes can be expensive, but if it’s something your elderly loved one needs, you’re probably not considering the cost.

Although costs vary depending on the type of feeding tube needed, generally, costs for feeding tubes run between $2,000 and $10,000.

There are additional expenses to consider, like:

• Daily costs associated with tube feeding
• Necessary supplies
• Follow-up care

Complications May Arise

It’s possible to use a feeding tube and have zero issues, but certain complications could arise. Some of these include:

• Tube leakage
• Diarrhea
• Stoma dermatitis
• Infections
• Constipation
• Dehydration 
• Perforation of the intestines
• Broken or plugged tubes

Senior Services of America: Helping Maintain Quality of Life for Elderly Adults

At Senior Services of America communities, we strive to make our residents as independent as possible. But that doesn’t mean we’re not on hand for any needs that arise. 

Contact us today to learn about Senior Services of America communities, and what we can do to help your elderly loved one live a comfortable, enjoyable, and independent lifestyle.