Study: One-Third of Advanced Alzheimer Patients Put on Feeding Tubes

More than one-third of nursing home patients who suffer from Alzheimer's disease and other forms of dementia receive their food through a stomach tube, even though the practice is of dubious medical value, according to researchers.

The study, reported in the Journal of the American Medical Association, suggests that the economics of Medicaid reimbursements favor the potentially harmful practice, and that large, for-profit nursing homes in urban areas are the most likely to use the devices.

In addition, researchers found that nonwhites were more likely to be given feeding tubes than whites.

The study, based on data from all 15,135 nursing homes licensed in the United States in 1999, found that 63,101 out of 186,835 patients with advanced dementia had feeding tubes.

Dr. Susan L. Mitchell of the Hebrew Rehabilitation for Aged in Boston, lead researcher, said the use of tubes was worrying "amid growing empirical data and expert opinion indicating that feeding tube use has no demonstrable health benefits in this population and may be associated with increased risks and discomfort."

While Alzheimer patients have increasing trouble swallowing, critics say feeding tubes can agitate patients and rob the of dignity. But the alternative, feeding them by hand, is more time-consuming and requires more staff attention.

The researchers suggested that some of the nursing homes clearly give patients feeding tubes because the practice is less costly.

''Staff time required for hand feeding is expensive,'' the researchers noted. And Medicaid, the government-run healthcare system for the poor and disabled, tends to pay more for tube feeding, providing for-profit homes with a further financial incentive to feed their patients by tube.

Other sources: Journal of the American Medical Association