G-tube for elderly person?

[Anonymous]

Anyone have experience with an elderly person getting a G-tube for supplemental feeds?

Dad's primary Dr. suggested one at his last appt. Dad has Parkinsons and, despite being well-fed by Mom, is malnourished. He is 136 pounds (technically he's 5ft9) and has 'anemia of chronic disease progression' which if I understand this, is his body not using the iron to make enough red blood cells due to the malnourishment.

Dad seemed interested (he does participate in his medical care despite some cognitive decline) and we're seeing his gasto dr about it next week. We're also interested to know if he could consume the caloric formula by mouth and not need a tube.

What are the downsides of a tube-do they get infected often? Is it hard for the caretaker to deal with?

[Anonymous]

The surgery involved seems to be the least of it, despite that they’re punching a hole into the person’s stomach.

I haven’t seen them get infected. I have seen them fall out but it seemed that can be resolved fairly simply.

The biggest adjustment I’ve seen is people’s digestive systems getting used to the nutritional product. Some get diarrhea at the beginning.

From the helper standpoint, it’s always been pretty simple. Plug in the receptacle, pour in the product, repeat until requisite amount is instilled, flush the tube with water.

I can’t speak to patient discomfort but none of the people I’ve seen complained of pain/discomfort.

Since it’s a surgical intervention, I’d want to know if there’s a non-surgical alternative, if he can still swallow without risking aspiration.

Good luck.

[Anonymous]

Thank you, PP. He can still swallow, so I am going to ask the gastro if it's possible for him to supplement by mouth with something (I assume a prescription formula?) to get the needed calories.

He suffers from constipation so if it causes some loose stools that might be a good thing.

[Anonymous]

This link has a lot of info: https://www.agingcare.com/articles/the-risks-and-benefits-of-feeding-tubes-for-seniors-445699.htm

I would make sure to ask about risk of infection. Also, my understanding is that typically these are permanent, so be sure to ask the doctors about that. Also ask that if you can take out if there is any risk to doing so.

[Anonymous]

My MIL has had Parkinson's for more than 2 decades now and despite being very frail and underweight, no one has suggested a feeding tube. My MIL, who is still very sharp mentally, wants as few interventions as possible, and she has already deplored the fact that years ago, she had a pacemaker put in, realizing that some deaths are perhaps less painful and drawn out than others.

[Anonymous]

I would never do this for my parent. I would think quality of life over longevity. Are you able to ask your parent about this? If not, put yourself in their situation and consider what they would want. This is not at all a decision for a doctor to recommend. My mom had early dementia. When it was her time to go it was her time to go. She had suffered more than her share. Please investigate hospice care. My mom was in it for 3 years.

[Anonymous]

Anonymous wrote: Anyone have experience with an elderly person getting a G-tube for supplemental feeds?

Dad's primary Dr. suggested one at his last appt. Dad has Parkinsons and, despite being well-fed by Mom, is malnourished. He is 136 pounds (technically he's 5ft9) and has 'anemia of chronic disease progression' which if I understand this, is his body not using the iron to make enough red blood cells due to the malnourishment.

Dad seemed interested (he does participate in his medical care despite some cognitive decline) and we're seeing his gasto dr about it next week. We're also interested to know if he could consume the caloric formula by mouth and not need a tube.

What are the downsides of a tube-do they get infected often? Is it hard for the caretaker to deal with?

Is it difficult for the patient to deal with should be the question being asked —not the care taker.

[Anonymous]

Anonymous wrote:I would never do this for my parent. I would think quality of life over longevity. Are you able to ask your parent about this? If not, put yourself in their situation and consider what they would want. This is not at all a decision for a doctor to recommend. My mom had early dementia. When it was her time to go it was her time to go. She had suffered more than her share. Please investigate hospice care. My mom was in it for 3 years.

OP here-I noted in my OP that Dad participates in his medical care and is interested in it, he is concerned about his weight loss and inability to gain (I eat, Doc, I can't seem to keep any weight on-he said). The anemia caused by the malnutrition is exhausting for him and treating it is hard on him (infusions and lots of blood draws).

[Anonymous]

Anonymous wrote:

Anonymous wrote: Anyone have experience with an elderly person getting a G-tube for supplemental feeds?

Dad's primary Dr. suggested one at his last appt. Dad has Parkinsons and, despite being well-fed by Mom, is malnourished. He is 136 pounds (technically he's 5ft9) and has 'anemia of chronic disease progression' which if I understand this, is his body not using the iron to make enough red blood cells due to the malnourishment.

Dad seemed interested (he does participate in his medical care despite some cognitive decline) and we're seeing his gasto dr about it next week. We're also interested to know if he could consume the caloric formula by mouth and not need a tube.

What are the downsides of a tube-do they get infected often? Is it hard for the caretaker to deal with?

Is it difficult for the patient to deal with should be the question being asked —not the care taker.

OP here-my Mom is the caretaker (I am there daily, but it's mostly her as I work full time, commute 2 hrs a day and am still parenting a dc). I am learning along this journey that his well being affects hers-they are choosing for him to remain home so it is a consideration in regards to caretaking. For better or worse and not neccessarily what 'I' think is best.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would never do this for my parent. I would think quality of life over longevity. Are you able to ask your parent about this? If not, put yourself in their situation and consider what they would want. This is not at all a decision for a doctor to recommend. My mom had early dementia. When it was her time to go it was her time to go. She had suffered more than her share. Please investigate hospice care. My mom was in it for 3 years.

OP here-I noted in my OP that Dad participates in his medical care and is interested in it, he is concerned about his weight loss and inability to gain (I eat, Doc, I can't seem to keep any weight on-he said). The anemia caused by the malnutrition is exhausting for him and treating it is hard on him (infusions and lots of blood draws).

Before doing something so invasive, I'd get a second opinion.

Some elderly people are anemic, and not because they eat too little, but because they don't eat the right things.
Others are anemic because they have small intestinal bleeds. This is what's happening to my MIL.

Also, take his complaints seriously, but with an informed viewpoint. Patients like him lose weight in the course of their disease, and there isn't a lot that can be done. They need to be kept moving, and have regular physical therapy. That also stimulates their appetite and helps manage constipation. Patients like him will be fatigued, in great part due to their medication for Parkinson's, and those can be tweaked.

I would askance at any doctor who jumps to gastric feeding for that profile of patient. Go see someone else before making that decision.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would never do this for my parent. I would think quality of life over longevity. Are you able to ask your parent about this? If not, put yourself in their situation and consider what they would want. This is not at all a decision for a doctor to recommend. My mom had early dementia. When it was her time to go it was her time to go. She had suffered more than her share. Please investigate hospice care. My mom was in it for 3 years.

OP here-I noted in my OP that Dad participates in his medical care and is interested in it, he is concerned about his weight loss and inability to gain (I eat, Doc, I can't seem to keep any weight on-he said). The anemia caused by the malnutrition is exhausting for him and treating it is hard on him (infusions and lots of blood draws).

Before doing something so invasive, I'd get a second opinion.

Some elderly people are anemic, and not because they eat too little, but because they don't eat the right things.
Others are anemic because they have small intestinal bleeds. This is what's happening to my MIL.

Also, take his complaints seriously, but with an informed viewpoint. Patients like him lose weight in the course of their disease, and there isn't a lot that can be done. They need to be kept moving, and have regular physical therapy. That also stimulates their appetite and helps manage constipation. Patients like him will be fatigued, in great part due to their medication for Parkinson's, and those can be tweaked.

I would askance at any doctor who jumps to gastric feeding for that profile of patient. Go see someone else before making that decision.

His primary doc, who suggested it, wants him to get a 2nd opinion from a gastro so we're doing that next week-his primary dr was just suggesting it as a possibility since Dad and us are concerned about his weight. His hematologist has done extensive testing and doesn't feel that he's bleeding, feels that it's malnutrition causing the anemia. He does eat, believe me Mom is a good cook and puts home cooked, yummy meals in front of him everyday ( I see them daily and eat there myself at least once a week). When they were in rehab last year (after they both fell) the rehab place was giving him ice cream 3 times a day LOL
I want to ask the gastro dr (I'm going to this appt) if there is something like formula (not sure what it would be called for adults) that he could drink a few times a day, by mouth, that could give him enough calories in addition to meals. I would think, if that was possible, then it's better than a g-tube. He's soooo thin, no fat at all.

Movement...is an issue. He had to stop a medication (whose name eludes me) that he'd been on for many years successfully, because it started to cause him horrible hallucinations. But it helped with mobility, so he's slowed down even more. He doesn't want physical therapy...this upsets me because I know he needs it and the last 2 drs visits it was prescribed and he won't let Mom schedule it. I agree that it would help with the constipation. I'm going to bring it up in front of the gastro, maybe they can get through to him.

[Anonymous]

Does he just want to suffer forever? I really don’t get this. Would you do this to your dog?

[Anonymous]

Ignore the death-mongers. They don’t know what they’re talking about. A G-tube is not an extraordinary measure. He doesn’t sound ready to quit and neither do you or your mother.

[Anonymous]

Anonymous wrote:Ignore the death-mongers. They don’t know what they’re talking about. A G-tube is not an extraordinary measure. He doesn’t sound ready to quit and neither do you or your mother.

Thank you. Yes, he is not ready to quit, he wants to gain some weight. He does occasionally go out to get a meal or ice cream, if he's having a good day (I push the wheelchair, and drive of course) and I even got him out on the beach this week in a beach wheelchair (but he wouldn't let me roll him in the water because 'that can't possibly end well' LOL still has some humor!) I'm hoping that better nutrition might mean more good days and less issues with anemia.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would never do this for my parent. I would think quality of life over longevity. Are you able to ask your parent about this? If not, put yourself in their situation and consider what they would want. This is not at all a decision for a doctor to recommend. My mom had early dementia. When it was her time to go it was her time to go. She had suffered more than her share. Please investigate hospice care. My mom was in it for 3 years.

OP here-I noted in my OP that Dad participates in his medical care and is interested in it, he is concerned about his weight loss and inability to gain (I eat, Doc, I can't seem to keep any weight on-he said). The anemia caused by the malnutrition is exhausting for him and treating it is hard on him (infusions and lots of blood draws).

Before doing something so invasive, I'd get a second opinion.

Some elderly people are anemic, and not because they eat too little, but because they don't eat the right things.
Others are anemic because they have small intestinal bleeds. This is what's happening to my MIL.

Also, take his complaints seriously, but with an informed viewpoint. Patients like him lose weight in the course of their disease, and there isn't a lot that can be done. They need to be kept moving, and have regular physical therapy. That also stimulates their appetite and helps manage constipation. Patients like him will be fatigued, in great part due to their medication for Parkinson's, and those can be tweaked.

I would askance at any doctor who jumps to gastric feeding for that profile of patient. Go see someone else before making that decision.

His primary doc, who suggested it, wants him to get a 2nd opinion from a gastro so we're doing that next week-his primary dr was just suggesting it as a possibility since Dad and us are concerned about his weight. His hematologist has done extensive testing and doesn't feel that he's bleeding, feels that it's malnutrition causing the anemia. He does eat, believe me Mom is a good cook and puts home cooked, yummy meals in front of him everyday ( I see them daily and eat there myself at least once a week). When they were in rehab last year (after they both fell) the rehab place was giving him ice cream 3 times a day LOL
I want to ask the gastro dr (I'm going to this appt) if there is something like formula (not sure what it would be called for adults) that he could drink a few times a day, by mouth, that could give him enough calories in addition to meals. I would think, if that was possible, then it's better than a g-tube. He's soooo thin, no fat at all.

Movement...is an issue. He had to stop a medication (whose name eludes me) that he'd been on for many years successfully, because it started to cause him horrible hallucinations. But it helped with mobility, so he's slowed down even more. He doesn't want physical therapy...this upsets me because I know he needs it and the last 2 drs visits it was prescribed and he won't let Mom schedule it. I agree that it would help with the constipation. I'm going to bring it up in front of the gastro, maybe they can get through to him.

Hmm. The hematologist just gave you a catch-all diagnosis, OP. Essentially your father's body is not working well enough for him to absorb the iron, B vitamins and folate that he's getting through his diet (and probably he's not getting enough of these through his diet anyway). Is there a reason why he's not getting supplements for B12, folate and iron? Iron supplements cause constipation, BTW.

He MUST do physical therapy. This is essential for his long-term quality of life.

I hear you about the medication that causes hallucinations - name escapes me too, but yes, it's hallucinations on one side and mobility block on the other. Sometimes you can adjust the dose of other meds to take the place of this one, and recover a bit of mobility. Does he have a pump that delivers meds through the bloodstream? It's more sensitive than injections and reduces the risk of painful cramps.