Gastrostomy Tube (G-tube)

Feeding Tube (Gastrostomy-Tube or G-tube) for Hospice patients

Definition: A G-tube is a feeding tube inserted directly into the stomach through the skin and stomach wall.

Caring for a loved one at End of Life is an emotional roller coaster. Caught up in this stressful time, we can forget to weigh the risks and benefits when asked to make decisions about more tests or procedures.

In my experience, when a person has a poor appetite, is loosing weight or is no longer able to swallow, the family’s main concern is that their loved one not starve to death. The idea of starvation brings to mind horrible images of death. These images feed our worries and work against our ability to make clear, rational and compassionate decisions around whether or not to have a G-tube procedure.

It is vital that families and patients (if able) are included in the decision making process. Once armed with the pros and cons of G-tube placement during End of Life Care, a clear more rational decision can be made. And, of course, it’s the patient’s and family’s choice that must be honored.

Quality of life is an important consideration in this decision and one that is often neglected in our fast paced “keep the patient alive at all costs” hospital environment. Though this attitude is changing, many medical professionals still feel they have failed the patient and family if death comes. This drives doctors to do everything to keep the patient alive.

When a patient no longer eats or drinks, the body’s metabolism changes and a sense of euphoria follows as a result of this change.

A hospice patient’s wife told me that while her husband was in the hospital (before hospice), she felt pressured into having a G-tube placed in her husband. She later regretted her decision.

Here are some other things to consider:

1. It’s a surgical procedure and requires some sedation and pain medication.

2. Any surgery brings discomfort and the risks of bleeding, infection and reactions to medication.

3. A common method of G-tube placement requires that a tube be passed from the mouth down into the stomach. Though not terribly complicated, it’s not a pleasant procedure.

4. If a G-tube is placed while a person can still swallow, are we robbing them of their appetite … and the pleasure that eating brings?

5. In the dying process, the body naturally becomes dehydrated. G-tube feedings can overload a failing body with fluid and can extend general discomfort. And once fluid overload has occurred, it’s almost impossible to get the fluid out of the body.

6. You can ask your doctor to write an order for “No G-tube” as an Advanced Directive.

Remember when a patient no longer eats or drinks, the body’s metabolism changes and a sense of euphoria follows as a result of this change.

It’s imperative that a pro and con discussion happen before the G-tube is placed, because once in place, the decision to stop the tube feedings can feel burdensome and difficult.

NOTE: The above information is general in nature and each patient’s stage of illness needs to be considered before making a decision whether or not to have a G-tube placed.