Marcus Institute Scientists Contribute to Dementia Care Best Practices

Recently, a study published in the Journal of the American Medical Association (JAMA) highlighted the dramatic decrease in feeding tube use by patients with end stage dementia over the last 15 years.

Researchers from Hebrew SeniorLife’s Hinda and Arthur Marcus Institute for Aging Research reviewed data on more than 71,000 advanced dementia patients and found that the proportion of them receiving feeding tubes declined from 11.7% in 2000 to 5.7% in 2014. Among white patients, insertion rates declined from 8.6 to 3.1% while rates in Black patients declined from 37.6-17.5%. For both groups, the proportion of patients with advanced dementia and unable to eat on their own who received feeding tubes decreased by approximately 50%.

According to Susan L. Mitchell MD, MPH, lead author of the study and Director of Palliative Care Research at the Marcus Institute, “This decline parallels the emergence of research, expert opinion, and recommendations by national organizations discouraging this practice.”

Over the last 20 years, Dr. Mitchell and other Marcus Institute researchers have conducted many studies on the terminal nature of dementia and the effects of feeding tube use on elderly patients with dementia. Their findings have contributed greatly to the overall decline in feeding tube use in recent years.

As Dr. Mitchell told The New York Times, it’s “becoming the prevailing wisdom” among clinicians, as studies have proven that use of feeding tubes can be traumatic for patients and does not significantly extend their life.

In the future, to ensure that expert recommendations are disseminated, researchers argue that fiscal and regulatory policies are needed to discourage tube-feeding and promote a palliative approach to feeding problems for people with dementia.