From the Spanish Society of Geriatrics and Gerontology (SEGG) have released a series of recommendations for employment nasogastric tube in the case of people with advanced Alzheimer’s disease who have swallowing difficulties. They are the following:
The decision to implant a nasogastric tube must be continually reassessed according to the evolution of the patient.
1. Nasogastric tube feeding in patients with advanced dementia and great difficulties in swallowing has not been scientifically proven to offer benefits in improving nutritional statusnor prolong survival or improve the quality of life in these patients and can cause discomfort to the patient and risks such as pulmonary aspiration of food.
2. For this reason, the clinical practice guidelines of the main Scientific Societies specialized in dementia consider the use of a nasogastric tube in this context as a futile treatment and do not recommend its use.
3. The basic care that ensures comfort measures, pain control, natural nutrition, psychological and spiritual support to the sick person and family members, should be maintained until the end of life, preferably administered by experts in palliative care and/or geriatrics.
4. For these reasons, decisions about how to deal with feeding difficulties in these patients should be made carefully in each individual caseconsidering the scientific knowledge mentioned, the values and preferences that the person may have expressed during his life and the opinion of the main caregivers.
5. Ideally, the decision to place or not place a nasogastric tube should be made consensual manner between the relatives and/or the legal guardian of the patient and the health personnel responsible for their care, assessing all the aforementioned aspects. The debate that includes the doubts, concerns and fears that these decisions generate in the last phases of life is necessary and recommendable.
6. As with other palliative treatment or medical decisions, the decision to implant a nasogastric tube is not final. Its continuity or not, must be continually reassessed according to the evolution of the patient.