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Ethical Aspects, Expectations, and Outcomes Associated with PEG in Dementia

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Book cover Geriatric Gastroenterology

Abstract

Percutaneous endoscopic gastrostomy (PEG) tubes are often placed as a means of feeding patients with terminal dementia who eat poorly. The decision to place a PEG involves ethical dilemmas and has become controversial, as data demonstrate that PEGs do not improve life expectancy, quality of life, or nutritional status in dementia, nor has it reduced the tendency to aspirate or heal pressure ulcers. Often, PEGs are placed prior to full evaluation for reversible factors. A multidisciplinary approach to evaluate the patient for reversible factors and alternate means of feeding should be utilized along with a meaningful discussion with the caregiver prior to using PEGs as a last resort. Undue expectations should not be put forth; a reasonable understanding of the process and outcomes by the providers and caregiver would be in the best interests of the patient.

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Author information

Authors and Affiliations

  1. New York Medical College, Valhalla, NY, USA

    T. S. Dharmarajan MD, FACP, AGSF (Professor of Medicine, Associate Dean) & C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF (Adjunct Professor of Medicine)

  2. Department of Medicine, Montefiore Medical Center (North Division), 600 East 233rd Street, Bronx, NY, 10466, USA

    T. S. Dharmarajan MD, FACP, AGSF (Vice Chairman)

  3. Division of Geriatrics, Montefiore Medical Center (North Division), 600 East 233rd Street, Bronx, NY, 10466, USA

    T. S. Dharmarajan MD, FACP, AGSF (Clinical Director)

  4. Geriatric Medicine, Fellowship Program, Montefiore Medical Center (North Division), 600 East 233rd Street, Bronx, NY, 10466, USA

    T. S. Dharmarajan MD, FACP, AGSF (Program Director)

  5. Division of Geriatrics, Montefiore Medical Center (North Division), 600 East 233rd Street, Bronx, NY, USA

    Krishna P. Aparanji MD

  6. Robert Wood Johnson School of Medicine, Drexel University School of Medicine, Philadelphia, USA

    C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF (Clinical Professor of Medicine)

  7. Gastroenterology, Hepatology and Nutrition, Saint Peter’s University Hospital, New Brunswick, NJ, USA

    C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF (Chief)

Authors
  1. T. S. Dharmarajan MD, FACP, AGSF
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  2. T. S. Dharmarajan MD, FACP, AGSF
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  3. T. S. Dharmarajan MD, FACP, AGSF
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  4. T. S. Dharmarajan MD, FACP, AGSF
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  5. Krishna P. Aparanji MD
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  6. C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF
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  7. C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF
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  8. C. S. Pitchumoni MD, MPH, FRCP(C), MACP, MACG, AGAF
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Corresponding author

Correspondence to Krishna P. Aparanji MD .

Editor information

Editors and Affiliations

  1. Hospital, Department of Medicine, Saint Peter’s University, 254 Easton Ave, New Brunswick, 08901, New Jersey, USA

    C. S. Pitchumoni

  2. (North Division), Department of Medicine, Montefiore Medical Center, 600 East 233rd Street, Bronx, 10466, New York, USA

    T. S. Dharmarajan

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Dharmarajan, T.S. et al. (2012). Ethical Aspects, Expectations, and Outcomes Associated with PEG in Dementia. In: Pitchumoni, C., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1623-5_15

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  • DOI: https://doi.org/10.1007/978-1-4419-1623-5_15

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