Feeding tube - Resource that's helping me discern this - (Catholic perspective)

elhijo

Hello ALZ Connected,

I've received much love and support over the years from ALZ Connected and ALZ specialists that I thought I would share a resource with you all. Since I'm Catholic this post is from the Catholic perspective. I think it could benefit anyone though going through deciding what's right, or not right, when it comes to a feeding tube.

The book is called "We are the Lord's, A Catholic Guide to Difficult End-of-Life Questions" by Fr. Jeffrey Kirby, STD.

Presently, I'm going through a very difficult situation where my mom has severe dysphagia. It's so bad she can't eat or drink via the mouth anymore. Aspiration pneumonia hospitalizations (horrible experiences) and ER visits lead me to conclude she either passes from not eating or there is a feeding tube. Doctors have told me not to use a feeding tube and basically not feed her and 'let her be' via hospice.

One doctor had a completely different point of view and was very clear about my mom's condition. She was pro feeding tube, however. I am thankful for her directness and point of view.

I'm still discerning what the right thing is to do and don't like that the hospice guy is against the feeding tube, but he has his own point of view. He did explain the possible complications that can happen with this and while I appreciate his info, I'll think I'll make him hush about it now. The book talks about feeding tubes and why it's unChristian and never morally acceptable to let someone thirst to death or starve to death, even if you have to use mechanical/artificial means to provide food and water. To not do this, he calls that a form of euthanasia which is morally unacceptable to Catholic teaching. It does give an exception like if the person's body cannot assimilate food and water and/or food and water would cause harm to that person. But it gives a lengthy explanation of what this would mean. He also goes into why certain doctors advocate somewhat strongly at times, for things that are against someone's faith and how to go about handling that situation.

I thought I would share it as it has already helped me in the few pages I've read from it, and it may help someone get clarity or direction on a feeding tube or other end of life matters, even if they aren't Catholic.

Thanks to all who have helped me throughout this journey. I didn't ask for it, but God lodged me with it, and now I just have to press onward. It's not an easy or clear road but the book gave me a lot of direction and clarity.

God Bless,

elhijo

M1

Eliho, in thirty plus years of general medical practice i only once put a feeding tube in, and that was in a nineteen year old with a serious but treatable illness who had prospects of complete recovery (and did in fact eventually recover). I would never put a feeding tube in a demented elderly person. At the end of life, hunger and thirst are blunted, and the lack of food and water are not experienced the same way as if you imagined yourself hungry or thirsty. I would recommend the book "hard choices for loving people" as additional reading on the subject.

Quilting brings calm

My step-dad passed away Feb 28. Here’s what I saw the last two weeeks: He didn’t want to eat. Wasn’t hungry, wasn’t Thirsty. Had to be persuaded to take more than a bite or sip. Had to be hand fed.

I truly believe that was all due to his body shutting down and internally he was no longer capable of processing food. I think you will see this issue differently when it’s time and the situation is unfolding in front of you. It’s not helping her die before her time- it’s acknowledging that her time has come. A feeding tube interferes with that and may cause pain and suffering that your loved one won’t be able to tell you about.

Something else to consider: if 10 knowledgeable people had one opinion about any other topic, abd only one person had a different opinion- which direction would you lean? For example-whether or not you should buy a specific product.

harshedbuzz

@elhijo said:

It does give an exception like if the person's body cannot assimilate food and water and/or food and water would cause harm to that person. But it gives a lengthy explanation of what this would mean. 

This may very well be where you mom's condition lies now which is why you are being given the advice you are. The above is the very description of end-stage dementia. We are wonderfully designed. As the brain become so damaged it can no long act as control center for the body, the mind no longer experiences hunger or thirst for the food or water that can do more harm than good.

My BIL was an ER doc at a Level I trauma center. He cared for his medically fragile mom in his home for over 5 1/2 years. When she reached the transition to active dying, he explained the decision not to intervene by explaining that her body was unlikely to be able to process fluids and giving them would be akin to drowning her.

HB

fmb

Elhijo, my heart goes out to you for this painful dilemma in which you find yourself. My DH also has dysphagia from a stroke and Stage 7 ALZ. In recent weeks his ability to swallow has become more and more impacted, having trouble with even pureed food and thickened liquids. As his body slowly shuts down, he has lost a great deal of flesh and muscle, losing over 40 lbs. since January.

When he reaches the point where he can no longer take in food and water, there will be no feeding tube or artificial hydration. God is calling him home, and while I would do nothing to hasten DH's passing, neither will I stand in the way of God's Will.

This video by Fr. Kirby goes into a deeper explanation of when it is acceptable and even a moral duty to withhold food and drink by artificial means as the body shuts down near the end of life.

https://www.youtube.com/watch?v=opvwtC-d360&list=PLfAMkqREoxMuhtiT8SxAJHym04WlGXYmk&index=10

elhijo

Thanks again to everyone who replied. The thing is my mom can indeed assimilate water. When we've been to the ER she does get water through the IV and feels alright afterward and looks good and nourished. She's just lost the ability to swallow but otherwise yes she can assimilate water. And I think so for food. It's worth a shot for the peg tube. If my mom had something like stage-4 cancer (heaven forbid) where the cancer would be causing death, then yes it would be something else. But in this case, it's not having food and water that is causing death. I'm surprised how bad her dysphagia has gotten in these last 2 days. She can't swallow anything anymore, even with the thickener (tried all kinds of thickeners over the last year). She does want/crave for water and food though so it would be morally wrong to deny this. It's a difficult situation I know and everyone's different but I have to try something(s). She is now with at-home hospice in case things do go very bad. Not really holding my breath for what hospice can deliver since it (like home-health) seems to be an overscheduled business enterprise, but at least it's something.

Thanks