Discontinue tube feeding

  1. 0
    In your experience when a patient has entered end of life phase and family decides to dc continous tube feedings,is it completely dc'd at once or gradually the rate is lowered? I would think that discontinuing at once would be the kinder thing to do rather than drawing out the process but I've heard otherwise from another hospice rn recently... I just don't understand her rationale that the body needs to "get use to the lack of food" and think she might be referring back to when patients are started back on PO feedings, not dying.. I'm still new to hospice and could be wrong so thought I'd seek more experienced advice. This is all hypothetical at moment so dont want to bother md for his opinion right now. Thanks!

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  2. 10 Comments...

  3. 5
    Where I work we always just DC it completely, no tapering off.What would be the point of doing it gradually?
  4. 3
    I have never seen tapering of tube feeds, especially in end of life. Her rationale just doesn't make sense.
    Daisy_08, BeesMama, and leslie :-D like this.
  5. 0
    Yeah I'm really starting to have my doubts about this nurse's credibility... It's hard when you're new and can't trust your "very experienced" coworkers advice. I have to look EVERYTHING up - but I guess that's a good way to learn the most up to date EBP. Thank goodness for Allnurses!!!!
  6. 4
    We let the patients body tell us what to to. If there are no bowel sounds or pt is congested, that is telling us she cannot process the feeding and it has to stop, not taper. Usually by checking the residuals, the amount of feeding has been decreasing slowly, but not always the case. I always explain it that we stop the feeding because the body is shutting down, we do not stop feedings to shut the body down, big difference between the two.

    I would def. look everything up at first. You will see who is giving you correct information after a while and know who to go to with questions.

    As a GN, before I took NCLEX, the hospital I worked at paired me with an LVN/GN, to "learn the ropes" she had been there forever and "knew" everything. I didn't trust her or what she told me so I did the same thing and would look everything up. Well, I passed, she didn't. Be wary of someone who seems to "know it all" I would trust someone more who didn't have a problem saying "I don't know" than someone who had an answer for everything.

    Good luck.
    Daisy_08, tnmarie, leslie :-D, and 1 other like this.
  7. 1
    i was a hospice nurse for several years and not once did we ever taper off fdgs.
    if a pump is running at 125ml/hr, that is still only 1/2 cup/hr...
    so, what's to taper?

    i cannot think of one medical indication where tapering would be warranted.
    i would advise you to do your own research, before readily believing what another nurse tells you.
    your instincts were spot on, so good for you.

    leslie
    aphillipi likes this.
  8. 3
    tapering is not indicated or of any value with TFs
    DC sometimes results in reduction of other noxious symptoms.
    leslie :-D, Daisy_08, and tnmarie like this.
  9. 4
    The fluid part of tube feeding can cause respiratory distress and that's very uncomfortable and scarey for a hospice patient. DCing completely is the thing to do.
    Nurse_Diane, leslie :-D, Daisy_08, and 1 other like this.
  10. 1
    (I know this is different)
    I used to work at a pediatric hospice, and often times what we would do is slowly change from full strength, to half strength (pedialyte) to just pedialyte and then slow it down from there.
    Again, I know you are talking adults, but just putting it out there that I've seen it done with kiddos before (though only a few times, to be fair)
    leslie :-D likes this.
  11. 0
    Quote from smurfynursey
    (I know this is different)
    I used to work at a pediatric hospice, and often times what we would do is slowly change from full strength, to half strength (pedialyte) to just pedialyte and then slow it down from there.
    Again, I know you are talking adults, but just putting it out there that I've seen it done with kiddos before (though only a few times, to be fair)
    what was the rationale for tapering fdgs this way, do you know?
    i'd love to understand...

    leslie


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