Why are feeding tubes commonly used in nursing homes? Are they used to benefit the residents, or to abuse them?
Although there are legitimate situations where hospitals and nursing homes use feeding tubes, doing so for a patient with advanced cognitive issues can amplify medical and emotional problems for that individual. In too many situations, feeding tube decisions are made based on financial rather than patient care factors.
Statistically, for-profit hospitals are more likely to use feeding tubes, as are larger hospitals and those with the highest level of intensive care unit use for patients in their last six months of life. Likewise, for-profit nursing homes, which make up 80 percent of the country’s nursing homes, are more likely to encourage families to get feeding tubes for their elders.
Nursing homes and hospitals together have a strong financial incentive to handle dementia patients through percutaneous gastrostomy tubes rather than to feed those patients by hand. Hand-feeding requires individually trained staff to carry it out, and staffing shortages are a nationwide concern for nursing homes.
The majority of the patients who are assigned feeding tubes have already been in the nursing home for some time, usually having exhausted their wealth enough to meet Medicaid qualifications. Most are “dual-eligible”, meaning that they qualify for both Medicaid and Medicare. Even minor infections can trigger a hospital visit for a nursing home patient. After the hospital visit, the patient becomes eligible for skilled nursing facility services for up to 100 days. This enables the nursing home to be paid roughly three to four times what they would have received from the patient’s Medicaid reimbursement alone.
A recent Wall Street Journal article highlighted the prevalence of reimbursements related to patients with feeding tubes, pointing out that private insurers and the federal government are more likely to pay out those claims when compared to patients without feeding tubes.
Sending a patient with advanced cognitive concerns to the hospital can negatively impact their condition by enabling them to develop disruptive behaviors that may even be treated with anti-psychotics. Pressure ulcers, too, are a common outcome due to the nutritional supplements and a lack of mobility. Rather than focusing on what’s best for the patient, standard procedure encourages nursing home staff to ship patients out to the hospital for feeding tubes and then back again to capitalize on reimbursements.
Committed to ensuring that your loved one is being cared for properly, My Elder responds quickly to any elder or elder care crisis to provide nursing home intervention, arrange for an immediate placement, prevent nursing home evictions, manage hospital crises, or aid with other elder care challenges.
But we can’t solve an ugly and dangerous situation unless you contact us immediately. Often waiting even one day is as harmful to a family member as taking no action at all. My Elder provides elder advocacy services to families. Talk to us about long-term planning, finding the right home for your loved ones, preventing crisis and abuse, and ensuring they receive the best care possible.
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