Nasogastric vs PEG tube for Alzheimer’s/dementia with swallowing problem

Based on my mother’s experience in having a feeding tube placed when she could no longer consume enough by mouth due to dysphagia, nasogastric tube would be a better choice.

A PEG tube (percutaneous endoscopic gastrostomy) is suited for those who required tube feeding but with intact cognitive function, ie still able to think and understand things rationally. For example in cases of those who suffer from ALS (Lou Gehrig’s disease), they would opt for a PEG tube placement to help to meet their nutrition and hydration needs. Through sharing of many ALS patients, they have indicated that a feeding tube helps to improve their quality of life.

However, in the case of a person with dementia or Alzheimer’s, it is strongly not advisable to place a PEG or any feeding tube that requires a surgical procedure. This is because they will surely rub on the tube because it is painful or uncomfortable which may lead to bleeding, dislocation of the tube or leakage of stomach acid. My mom rubs on her nasogastric tube often and I have to secure her tube properly via micropore tapes which needed to be changed often.

In terms of nasogastric tube, it is just inserted from the nose to the stomach hence there is no surgical procedure. If they pull out the tube, it can be reinserted by a nurse in the hospital.

You can watch the video in my channel on this topic:

Overall, the placement of the nasogastric tube has given my mother a better quality of life. She has regained her energy levels and vitality. While she was very picky on food and was willing to eat what she like (eg cakes, ice cream, biscuits), she had malnourishment which I believe partially contribute to her decline. Prior to tube feeding, she also had high blood pressure, high cholesterol,  diabetic and dehydrated (she was reluctant to drink water as she always choked in it).

It is now 7 months after putting her on tube feeding. Her blood pressure, cholesterol and blood sugar are under control. She also had a preexisting chronic hepatitis B and with good nutrition, the virus count in her blood is no longer detectable. However, the medication, entecavir is still being continued by doctors as once started, it has to be on for life.

Note: To prevent them from pulling out the tube, use specialised hand mittens to restraint them. My mother wears the hand mittens on long term basis (I take it out to clean her hands and put it back off, then change the hand mittens once every 4 to 5 days):


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