TUBE-FEEDING PREFERENCES AMONG NURSING-HOME RESIDENTS

OBJECTIVE: To determine the preferences of nursing home residents rega rding the use of tube feedings and to characterize the clinical, funct ional, and psychosocial factors that are associated with preferences. DESIGN: In-person survey. SETTING: Forty-nine randomly selected nursin g homes. PATIENTS/PARTICIPANTS: Three hundred seventy-nine randomly se lected, decisionally capable, nursing home residents. MAIN RESULTS: Th irty-three percent of participants would prefer tube feedings if no lo nger able to eat because of permanent brain damage. Factors positively associated with preferences for tube feedings include male gender, Af rican-American race, never having discussed treatment preferences with family members or health care providers, never having signed an advan ce directive, and believing that tube feeding preferences will be resp ected by the nursing home staff. Twenty-five percent of the participan ts changed from preferring tube feedings to not preferring tube feedin gs on learning that physical restraints are sometimes applied during t he tube feeding process. CONCLUSIONS: Demographic and social factors a re associated with preferences for tube feedings. The provision of inf ormation about the potential use of physical restraint altered a propo rtion of nursing home residents' treatment preferences.