[hospicenurse]

Recently our director has told us we will not cover feedings under any circumstances. Apparently this is something that she picked up from other agencies' policies. In the past we have covered it for certain patients, for example cancer of esophagus or mouth causing a hungry patient to be unable to eat. I'm curious about how other agencies are handling this issue.

Gail

[Angelica]

We cover it in select circumstances. Most recently we had a trisomy 18 infant on a feeding pump. Our pts with feeding pumps are few and far between, though.

[aimeee]

Now and then...if they must be tube fed we try to get them on bolus feedings, and try to get them switched to just an OTC liquid nutrition such as Ensure. We have had some luck with getting donations of various formulas too. The bottom line is we don't ever want the tube feeding to stand in the way of a patient coming onto service. So, the policy is no coverage of enteral feedings, but exceptions are made depending on circumstance.

[Yellow Rose RN]

My next door neighbor had a baby with Trisomy 10 and was on feedings. Hospice took off of their service when he was placed on these feedings. He was unable to take anything orally and was dying. Ended up, when the parents removed the feedings (for many reasons mostly due to his little body shutting down)... then Hospice stepped back in. I think that Hospice should cover feeding in certain situations...

[Mandee]

We cover tube feeding in pts who have certain cancers(esophageal etc..), we also cover it in pts with Alzheimers, dementia and end stage CVA.

Mandee

[saribeth]

It is not often that we have a pt with a feeding tube but we do encounter this and what our agency does it admit them as a home care pt. That way the supplies are covered and it does not drain our resources. HOWEVER, we are very flexable and have covered it before but we try to get the order for a bolus feeding to eliminate the pump etc!