To be alive vs. to live: Filipino elderly, nasogastric tubes, and the issue of artificial feeding in dementia

Authors: Carla Krishan A Cuadro, Janel Alexis O Herrera, Thomas L Quiros

Published: 2020-12-07

Abstract

AbstractBackgroundNasogastric tubes (NGTs) are part of the nutritional intervention of patients who present with dysphagia. While NGTs guarantee the unimpeded delivery of nutrients into a body, complaints about its discomfort and aftercare are rife. The provision of continuous nutritional support takes precedence over the NGTs’ infection and aspiration risks. The issue of artificial feeding takes a more urgent turn among individuals with dementia, where frequent pull‐outs and physical resistance are common. Using percutaneous endoscopic gastrostomy (PEG) tubes relieve one of NGT discomfort. However, research had questioned PEG tubes’ ability to improve patients’ nutritional status. For those who do use it, maintenance issues, pull‐outs, and cultural beliefs on ‘holes’ on the abdomen prevail. While most societies equate food intake as supportive of life, risking the use of feeding tubes with those with neurodegenerative conditions remains debatable. There is a paucity of research that investigate the lived experiences of elderly who wore NGTs. Using illness narratives of cognitively‐intact, verbal Filipino elderly, this project interrogated NGT insertion processes, living with the tube, bodily integrity, fullness vs. satiety, and what is amiss such that to be alive is discrepant from to live.