Use of PEG tubes in the cognitively impaired patient: dispelling the myths.

Difficulty eating is one of the markers of end-stage dementia and poses difficult care decisions for family members and health care providers. In particular, family members often struggle with the decision of whether to provide artificial nutrition via feeding tube. While it is important that surrogate decision makers be provided with information on the risks and benefits of artificial nutrition, studies have shown that many health care providers are misinformed about the rationale for recommending a percutaneous endoscopic gastrostomy tube. Current literature suggests that for the elderly patient with dementia there is little clinical evidence that artificial nutrition provides any benefit to the patient.