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Carol Bradley Bursack, Published April 26 2014

Minding our Elders: Would a feeding tube have been a better choice?

DEAR CAROL: My dad was 89-years-old and in a nursing home when he fell and broke his hip.

While he was in the hospital and supposed to be healing from the fracture he developed pneumonia. Then, when they X-rayed his lungs they found the start of lung cancer.

The doctor gave Dad antibiotics for his pneumonia but Dad continued to get worse. He couldn’t eat and went in and out of consciousness.

I wanted them to put in a feeding tube so that Dad received nourishment. The doctor disagreed. He said Dad was dying and that a feeding tube would just drag out his misery. He recommended hospice care.

I miss Dad so much and worry that I should have fought harder for them to use a feeding tube. – Gwen

DEAR GWEN: There are times when feeding tubes make sense, such as when there is hope that the person will eventually recover and/or they still have a strong will to live. Your dad’s situation was far more complicated than that.

A broken hip is extremely traumatic physically, mentally and emotionally for someone your dad’s age. Since your dad also had pneumonia and the start of lung cancer, even if his body could have survived awhile longer with a feeding tube it’s unlikely that he would have regained an acceptable quality of life. He would also have faced the risk of infection, aspiration of food into his already damaged lungs and other issues.

To take that concept still further, if your dad did recover from the broken hip and pneumonia, he’d likely have had to undergo surgery for his lung cancer. Then, if he recovered from the surgery, his next step would probably have been radiation and/or chemotherapy. That doesn’t sound like a pleasant way to finish a long life such as his.

Hospice care seems like the right decision for someone in your dad’s situation. Hospice can generally keep people comfortable and provide a better quality of life for the time that they have left. I believe that the doctor made the most compassionate decision possible for your dad. It’s also a decision that he may have been required to make based on your dad’s medical condition.

You did everything that you could for your dad, Gwen, so you have no reason to blame yourself. Still, sometimes we need help getting over guilty feelings even when they aren’t warranted. Hospice organizations generally offer grief counseling for up to 13 months after the death of the person they cared for. Please ask about this counseling if you haven’t already taken advantage of it. If you feel that hospice grief counseling isn’t enough, or too much time has passed since your dad’s death for you to qualify, look for a personal counselor.

Once you get some guidance, you’ll likely come to accept that you did the right thing. Then, you’ll be free to feel your dad’s spiritual presence with you without blaming yourself in any way for his death. He’d want you to get back to living your own life.


Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carolbursack@msn.com.