By Catherine Barrett

Sensible publication is easy-to-read and assists in instructing vital scientific talents with regards to tube feeding.

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Additional info for Gastrostomy Care: A Guide to Practice

Example text

Decisions for families are complicated by the stress of their family member’s acute illness. indd 22 24/05/2004 2:01:29 PM 23 Making Decisions on Tube Feeding A decision to insert a tube is also complicated by the symbolism attached to food. As discussed in Chapter 5 (page 97), having a tube inserted and being unable to eat or drink can represent significant psychosocial losses for the person and his or her family. A policy or guide for tube-feeding decisions can help to ensure that the complexities of the decision are adequately addressed, and that any decisions are genuinely person-centred.

Under what circumstances can tube feeding be ceased, and who has authority to authorise that it be ceased? • Has the legal position of the facility been determined? The views and preferences of the person who is to receive the tube feeding are central to the decision-making process. These preferences might be articulated by the person, or by his or her family members, or by other closely involved parties. If the person’s preferences cannot be ascertained, the legal process prescribed in the local jurisdiction for the appointment of substitute decision-makers must be followed.

Of management are different for every individual. The care team must be mindful of the ethical and medical dilemmas involved in management. Typical issues to consider when formulating management goals are: • the need to prevent choking and aspiration; • nutrition and hydration requirements; • the individual’s views and preferences; and • quality of life. The Box on page 12 provides a list of questions that should be addressed in drawing-up any management plan for dysphagia. It should be noted that dysphagia following an acute neurological event often resolves (either partially or completely).

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Gastrostomy Care: A Guide to Practice by Catherine Barrett
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