swallowing disorders, dysphagia, feeding tube awareness week, live your life pt, physical therapy, minneapolis, minnesota

Feeding Tube Awareness Week

| Rachel Wieneke

February 6-10, 2017 marks feeding tube awareness week. While feeding tubes, whether inserted through the nasal cavity or directly into the stomach, are essential in meeting nutritional needs for many children and adults, there is controversy surrounding the long-term use of feeding tubes with the geriatric population.

According to an article in The Hospitalist, permanent feeding tubes are placed when an individual develops a swallowing disorder, also known as dysphagia. This is often the result of a stroke, degenerative brain disease or other diseases that impact appetite and feeding1 The percutaneous endoscopic gastronomy (PEG) tube is often the recommendation for an adult with acute swallowing disorders. This tube is beneficial in meeting nutritional needs when the oral route is impaired and is often a more permanent placement. Permanent feeding tubes are also thought to decrease the risk of bedsores by increasing skin integrity.

Often times, controversy occurs when families and physicians are making the nutritional based decision to use a PEG tube for individuals with long term aspiration risks and progressive diseases, such as dementia. Permanent feeding tube use may not actually prevent the development of aspiration pneumonia in these individuals. In fact, according to an article published by the American Family Physician, the risk of aspiration pneumonia may actually be higher for those patients with both dementia and a feeding tube. This is due to the “continued reflux of gastric contents and aspiration of oropharyngeal secretions.”2 The same article in American Family Physician also reports that during later stages of cognitive decline and life, individuals may not experience sensations of hunger and may not have wished for his/her life to be prolonged via nutritional intake.

As a speech-language pathologist who treats swallowing disorders, I have worked closely with patients and families faced with the decision of permanent feeding tube placement. For some patients and families, the decision for a permanent feeding tube was an easy one to make, but for others it has been deeply emotional and difficult. Acknowledging and understanding a person’s end of life wishes and thoughts on feeding tubes prior to the event of one being placed can help ease the process. In the end, recommending a permanent feeding tube can be an emotionally challenging decision for a patient and his/her family. It is important to remember that this is an individual decision for the patient and his/her family, along with the physician.

At Live Your LifeTM we offer physical therapy, occupational therapy, speech therapy, personal training, acupuncture, massage therapy, health coaching and dietary services. Contact us today to set up your free consultation.

Health and Happiness,

Rachel Wieneke, M.A., CCC-SLP
Speech Language Pathologist
Live Your LifeTM

Bringing Physical Therapy & Wellness to You!

Rachel Wieneke, M.A., CCC-SLP, graduated from the University of South Dakota in 2012 with a Master of Arts degree in Speech-Language Pathology and currently holds a Certificate of Clinical Competency from the American Speech-Language-Hearing Association. She has experience in providing speech therapy to adolescents and adults, with increased focus in providing intervention for a receptive-expressive language, swallowing and cognition. Rachel is also certified in VitalStim Therapy which allows her to utilize neuromuscular electrical stimulation with her swallowing therapy.

As a therapist, Rachel values a patient centered approach and involves both the caregiver and patient when creating goals for intervention, as well as during her treatment sessions. She appreciates the relationships she builds with her patients and their families, as well as generalizing therapy to the home setting. Rachel believes that these aspects are vital in helping her patients succeed.

References

1To tube or not to tube. http://www.the-hospitalist.org/hospitalist/article/123197/tube-or-not-tube. Accessed on February 6, 2017.

2American Family Physician. http://www.aafp.org/afp/2002/0415/p1605.html Accessed on February 6, 2017.

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