Sheiman S L, Pomerantz J D
University of Pennsylvania School of Nursing, Philadelphia, USA.
J Nutr Health Aging. 1998;2(3):184-9.
Primary care providers for patients with endstage dementia are often confronted with difficult tube feeding decisions. Decreased food intake occurs with increasing age which can be worsened by dementia. Often the solution is to provide food by way of tube feeding. However, no improvement in survival has been found with the use of tube feeding in anorexia caused by endstage dementia. Several complications involving pulmonary, gastrointestinal and renal systems are common. Ethical and legal considerations weigh tube feeding as basic care versus a medical treatment. Nursing home and state regulations designed to prevent abuse challenge patient's rights to refuse tube feeding as a medical treatment. This review discusses the complications and issues surrounding the use of this practice in end stage dementia.
晚期痴呆症患者的初级护理提供者常常面临艰难的管饲决策。随着年龄增长，食物摄入量会减少，而痴呆症会使这种情况恶化。通常的解决办法是通过管饲提供食物。然而，在晚期痴呆症所致厌食症中，使用管饲并未发现生存期有所改善。涉及肺部、胃肠道和肾脏系统的几种并发症很常见。伦理和法律考量权衡了管饲作为基本护理与医疗治疗的问题。旨在防止虐待的养老院和州法规对患者拒绝将管饲作为医疗治疗的权利构成了挑战。本综述讨论了在晚期痴呆症中使用这种做法所涉及的并发症和问题。
