Decision Aid

TABLE 2: Surrogate Decision-makers’ Perceptions of Feeding Options at Baseline (n=255)
Advantages of Assistance with Eating by Mouth:
 Enjoyment of food and drink (40%)*
o Pleasure and satisfaction of eating and
tasting
o Enjoys the taste of food
o Have something to look forward to,
pleasure from eating
 Health and nutrition (35%)
o Better varieties of food
o Gets the proper nutrition
o Helps keep her weight on
 Effective (29%)
o Could not eat if she did not get assistance
o Ensures she does not eat too much and
choke
o The more encouraged he is the more he
will eat
 Dignity (20%)
o Dignity of eating by mouth
o It gives her a chance to be independent
o Satisfaction of being self-sufficient
Advantages of Tube Feeding:
 Complete nutrition (53%)*
o Consistently get correct amount of
nutrition
o Keep healthy/maintain weight
o Nourish body if choking prevents normal
eating
 Survival (22%)
o Keep person alive longer
o Ensures basic survival is they cannot feed
themselves
o Sustain life/extend life
 Other benefits (11%)
o Eliminates stress of eating
o Comfort for patient and family
o Skin turgor maintained, less bed sores
 Takes less time (7%)
o Less time to feed vs. by mouth
o Easier on the staff
o Avoids struggle of staff/patient effort
Disadvantages of Assistance with eating by Mouth:
 Unpleasant experience (26%)*
o Might not like the food she is given
o Spill a lot/messy
o Overfeeding, don’t know when to stop,
have to guess
 Loss of independence (19%)
o Less dignified than feeding themselves
o Builds dependency/discourages
independence
o Accelerate process of not being able to
feed himself if he gets assistance- hard to
change
 Choking (18%)
o Danger of aspiration or choking
o Food may go down wrong in lungs
o Can get strangled
 Uncertain/lesser amount of food or drink (18%)
o May not get enough nutrition
o Insufficient amount of food/concerned
about drinking
o She’ll eat enough to subside hunger but
not to maintain weight level
Disadvantages of Tube Feeding:
 Tube-related complications (38%)*
o Infections are possible, need a lot of care
to keep clean
o Discomfort, having tube in you
o Invasive- more risks, complications
 Concern about prolonging life inappropriately
(25%)
o Extend life when there is no quality
o May just prolong the inevitable
o I believe in natural death, not prolonging
life if he gets to a place he can’t digest his
food normally
 Less enjoyment or pleasure (22%)
o Lose psychological pleasure of eating
o No quality of life
o Mental anguish for person- cannot eat by
mouth, always thinking about food
 Against prior wishes (14%)
o It would go against his personal wishes
o Requested that she not be tube fed
o Person might not want it, against religion
* percent of surrogates whose response fell within this category