Close this search box.

Tube Feedings May Not Help Emaciated, Bed-Ridden Patient

Print Article


Frail, demented nursing home patients can eventually lose the ability to take food and fluids by mouth. When that process begins to occur tube feedings may be started. Doctors and family members may believe that such feedings prolong life and improve the ability to fight bedsores and disease. Dr. Thomas Finucane, a nationally recognized expert practicing Geriatric Medicine at Johns Hopkins in Baltimore, challenges that easy assumption. In a report for Elder Law Issues, Dr. Finucane explains:

Although it seems implausible, when faced with an emaciated, demented, permanently recumbent, poorly communicative patient with bedsores who is losing weight, clinicians and loved ones should remember there is no good evidence that administering tube feeding will help this patient.

Randomized trials are the gold standard for evaluating whether treatments are effective. Such trials are generally lacking with respect to tube feeding. Other data, some quite persuasive, have been developed, and these studies are virtually unanimous in showing lack of effectiveness.

Several lines of evidence suggest that tube feeding will not prolong survival when compared to a conscientious effort at hand feeding. Death rates are very high in the days and months after feeding tubes are placed.

No published paper suggests that tube feeding will reduce the risk of aspiration pneumonia; several trials find feeding tubes to be risk factors for the development of pneumonia. Aspiration pneumonia usually arises from inadvertent inhalation of either contaminated oral secretions or of regurgitated gastric contents. Tube feeding could not be expected to prevent either of these events.

Pressure sores have not been shown to improve when tube feeding is given. Once feedings are initiated, patients will produce more urine and stool, which are definite risk factors for pressure sores.

Risk of infection has not been reduced among tube fed patients. Serious and fatal infections have been shown to result from tube feeding.

Demented patients have not been shown to get stronger and function better with tube feeding.

Although it is difficult to know the experience of a noncommunicative person, there is no evidence that tube feeding reduces suffering. Restraints are more often used in tube fed patients.

Dozens of serious side effects have been reported as a result of tube feeding. Based on these data, it seems that tube feeding is overused in the care of patients with advanced dementia.

Legal battles over tube feeding have focused on comparing the benefits and burdens of the procedure. Benefits have been assumed, and burdens have usually been limited to the physical pain associated with insertion of tubes. Dr. Finucane challenges both sets of assumptions. He also challenges the medical community to undertake research to determine whether tube feedings really are beneficial.

Dr. Finucane’s analysis of medical studies, “Tube Feeding in Patients With Advanced Dementia,” was published in the Journal of the American Medical Association. Read the abstract or order his paper at

Stay up to date

Subscribe to our Newsletter to get our takes on some of the situations families, seniors, and individuals with disabilities find themselves in. These posts help guide you in the decision making process and point out helpful tips and nuances to take advantage of. Enter your email below to have our entries sent directly to your inbox!

Robert B. Fleming


Robert Fleming is a Fellow of both the American College of Trust and Estate Counsel and the National Academy of Elder Law Attorneys. He has been certified as a Specialist in Estate and Trust Law by the State Bar of Arizona‘s Board of Legal Specialization, and he is also a Certified Elder Law Attorney by the National Elder Law Foundation. Robert has a long history of involvement in local, state and national organizations. He is most proud of his instrumental involvement in the Special Needs Alliance, the premier national organization for lawyers dealing with special needs trusts and planning.

Robert has two adult children, two young grandchildren and a wife of over fifty years. He is devoted to all of them. He is also very fond of Rosalind Franklin (his office companion corgi), and his homebound cat Muninn. He just likes people, their pets and their stories.

Elizabeth N.R. Friman


Elizabeth Noble Rollings Friman is a principal and licensed fiduciary at Fleming & Curti, PLC. Elizabeth enjoys estate planning and helping families navigate trust and probate administrations. She is passionate about the fiduciary work that she performs as a trustee, personal representative, guardian, and conservator. Elizabeth works with CPAs, financial professionals, case managers, and medical providers to tailor solutions to complex family challenges. Elizabeth is often called upon to serve as a neutral party so that families can avoid protracted legal conflict. Elizabeth relies on the expertise of her team at Fleming & Curti, and as the Firm approaches its third decade, she is proud of the culture of care and consideration that the Firm embodies. Finding workable solutions to sensitive and complex family challenges is something that Elizabeth and the Fleming & Curti team do well.

Amy F. Matheson


Amy Farrell Matheson has worked as an attorney at Fleming & Curti since 2006. A member of the Southern Arizona Estate Planning Council, she is primarily responsible for estate planning and probate matters.

Amy graduated from Wellesley College with a double major in political science and English. She is an honors graduate of Suffolk University Law School and has been admitted to practice in Arizona, Massachusetts, New York, and the District of Columbia.

Prior to joining Fleming & Curti, Amy worked for American Public Television in Boston, and with the international trade group at White & Case, LLP, in Washington, D.C.

Amy’s husband, Tom, is an astronomer at NOIRLab and the Head of Time Domain Services, whose main project is ANTARES. Sadly, this does not involve actual time travel. Amy’s twin daughters are high school students; Finn, her Irish Red and White Setter, remains a puppy at heart.

Famous people's wills

Matthew M. Mansour


Matthew is a law clerk who recently earned his law degree from the University of Arizona James E. Rogers College of Law. His undergraduate degree is in psychology from the University of California, Santa Barbara. Matthew has had a passion for advocacy in the Tucson community since his time as a law student representative in the Workers’ Rights Clinic. He also has worked in both the Pima County Attorney’s Office and the Pima County Public Defender’s Office. He enjoys playing basketball, caring for his cat, and listening to audiobooks narrated by the authors.