Mom feels uncomfortable after taking liquids and usually coughs. She experiences hiccups too after liquid intake. We are considering getting my mom a PEG feeding tube on the recommendation of her neurologist. We are going for a second opinion and will decide after meeting with a gastroenterologist. Please share your experience on the following:
+ Are there any disadvantages of feeding via PEG? If yes, what are those?
+ Can we continue to feed her both ways wherein she continues to have solids/semi-solids orally from mouth and liquids can be given via PEG? The neuro confirmed that it's possible.
+ She's becoming weak by the day and taking liquids from mouth is becoming progressively difficult. Will PEG help improve her nutrition or food/liquid intake?
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pankaj911
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Hi Jean...thanks for your reply. I have read through some archived posts on PEG. My mom is not really in a position to decide, so we will need to decide for her. She mostly only repeats things or sings along hymns and songs.
My wife has been on an NG tube for over two years.. She was put on the tube whilst in hospital recovering from Aspiration pneumonia and looking very weak. We had asked for a 'best interest' meeting. I went into hospital the next morning to find her sat up in bed with a tube up her nose and a big grin on her face.
Advantages. A controlled diet. Complete nutrition. Prolonged life.
Disadvantages: No joy of food. Having to watch others eating.
All medication has to be liquid.
Don't know about a peg but NG tubes have to be changed every so often. A very simple procedure carried out in hospital as an out patient.
I don't know how it applies elsewhere but our hospital seems to interpret a signed DNR to include no surgical intervention. Hence the NG tube as opposed to a peg.
I administer medication through the tube. The feed supply company (Abbott) are brilliant.
Hope this is helpful, if you have any questions I'll try to help.
Thanks Ken! I will be sure to ask the Gastro specialist about the NG tube when we meet with him this weekend. Of course, for PEG there is a short surgery.
As for the disadvantages, the doctor told us that mom can continue to eat semi solids via mouth (as they don't cause her cough or any discomfort). So I guess it's going to be both ways.
The peg is a super bit of kit, it ensures that there is enough fluid intake,nutrition and medication. This keeps your loved one clear of UTI and away from hospitals.
pankaj, read through my posts and those of others - managing nutrition via a PEG can be impossible for some patients - and they try to pull it out sometimes, and you have to force them by holding their hands every few minutes - and the patient has to be at a 45 degree angle for 45 minutes , 6 to 8 times a day - they sometimes force themselves to slide and lie down and you again have to force them to stay up
This can be exhausting for the caregivers (you need at least 3 rounds of 8 hrs/day carers), usually family since carers-for-hire can be highly negligent of a patient that cannot commuicate
All this can be extremely distressful for the patient too, like being subjected to the torture/pain of being force held every few minutes for the whole
if your mom enjoys life i.e. reads the news, watches TV, goes out for shopping, plays with her grandkids but has problems talking/swallowing, then a PEG may be a good idea, otherwise it's prolongation of the pain and distress
however, there are both kinds of opinions about it, my dad had one and i am not in favor
Lastly, here is a response to my qs from someone else at another forum:
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(I'm not a doctor but I am a speech therapist who currently works with swallowing disorders in people with neurological conditions)
The best guidance I know of on this is the Royal College of Physicians (UK) report on Oral feeding Difficulties and Dilemmas: rcplondon.ac.uk/projects/ou...
I don't think it's a humane or not humane thing to do. I think that for some people it's the best thing ever and for some people the benefits are outweighed by the burdens.
In the UK we are moving away from the assumption that everyone will have a PEG tube. In fact, in the light of this report, I would say that the majority of people with dementia won't have a PEG tube.
However, there are people where their swallowing is impaired out of proportion to their overall condition. They might have a reasonable quality of life except for their very poor swallow, and they might be able to walk, do a lot of things independently but just not be able to manage to eat enough to maintain weight. Or maybe mealtimes have turned into an exhausting, stressful situation for everyone concerned, but the person still shows signs of enjoying other parts of their life. In those cases, a PEG is probably humane.
However, if the swallow is impaired in the context of advanced dementia and especially if the person is showing signs of significant distress, then I don't think it's humane. We are increasingly seeing this as a way of prolonging dying rather than prolonging life. And in fact the evidence suggests it isn't very good at prolonging life or preventing aspiration anyway.
If you want an American perspective, our NHS Trust have also adopted these guidelines from the American Geriatrics Society: ncbi.nlm.nih.gov/pmc/articl...
Hi there. My husband had a PEG. I was taught how to use it and administer food and meds. It kept him hydrated and his body healthy. It prolonged his life for nearly a year. The nurse from hosoital used to come to house to change tube. A simple procedure. I have no regrets about using it. The nutritionist who decided "recipe" was brilliant. Always listened to my concerns, and the company, abbott, who delivered food were always helpful. Good luck making your decision. Marie
Hubby Leon has had P.E.G for almost a year, is booked in next week to get it changed. Definately prolonged his life, as he would have starved otherwise. No major issues with it, all meds go through it too. I dip my finger in a beer and give it to him through his peg, gives him the taste and satisfaction of having a beer, at happy hour at the care facility where he now is, once a month.
About half a bottle, just slowly let it go through the tube, stop start stop start, naturally flush with water before and after. Was also told at the beginning that he could have food/drinks by mouth but that was not possible as Leon choked immediately something was in his mouth, even the stuff to put on his tongue to clear the white coating from some of the meds. It just gives him the satisfaction of being involved in Happy Hour, which is great
You have just reminded me, a few weeks ago the tube was blocked and I had tried all the usual tricks, soda water Coca Cola etc. About to give up I poured myself a beer as it fizzed up in the bottle I thought why not give it a try? It cleared the tube instantly so I have given some alcohol and no harm was done.
My father was fitted with a PEG at the end of March. He still managed to aspirate and got pneumonia 2 weeks ago. Hes been in hospital with that and somehow got C. difficile as well. PEG we are finding is not fail safe. He would have probably died without it and after initially saying no to being fed that way, he changed his mind and wanted it. I think the most important thing is if the person can make the decision for them self, let them be the judge of what they want.
Hi, my Mum had a PEG fitted in hospital almost 2 months ago and so far it's great, Mum was getting so exhausted trying to eat and drink enough before the tube was fitted. She still has small amounts of pureed food and drinks through the day but just for the flavours. All hydration and nutrition needs can be met via her Nutricia feed bags. Feeds her over night while she sleeps. She feels so much better. It's a very personal decision but Mum's happy she had it fitted.
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