Abstracts

Seniors

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More caution about tube feeding

Article Abstract:

It is debatable that severely ill cognitively defective people required tube feeding or are likely to benefit. Suggesting more aggressive use of tube feeding shows unjustified optimism, based on mortality data according to two physicians at the Johns Hopkins Bayview Medical Center.

Health aspects, Aging, Research, Statistics, Enteral nutrition, Percutaneous endoscopic gastrostomy, Tube feeding

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Elective discontinuation of life-sustaining mechanical ventilation on a chronic ventilator unit

Article Abstract:

Results of a six-year study are presented on the decision to discontinue mechanical ventilation on nursing home patients, focusing on the terminal weaning procedure. Terminal weaning (TW) involves the removal of mechanical ventilatory support, but leaves the artificial airway in place. Medication is given at the onset of TW; family and physician typically remain at bedside until death occurs, typically within six hours.

Nursing home patients, Medical care decision-making authority (Law), Medical care decision making authority (Law), Right to refuse treatment, Treatment refusal

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Limiting life-sustaining treatment as a matter of (insurance) policy

Article Abstract:

Limiting life-sustaining treatment for elderly dying people as a matter of policy related to Medicare and insurance coverage is discussed. There are problems in that people have been known to change their minds and that it is not always easy to know who is near death. Social needs of the frail elderly may not be clearly distinguished from medical ones. Decisions must be made for the cognitively impaired, and it is not clear how that would be done. Already Medicare expenditures are limited for the very old, especially if they are near death.

Planning, Usage, Economic aspects, Diagnosis, Terminally ill persons, Terminally ill, Social policy, Demographic aspects, Caregivers, Palliative treatment, Palliative care, Beliefs, opinions and attitudes, Ethical aspects, Dementia, Health insurance industry, Nursing home care, Medicare, Home care services, Health care rationing, Life support systems (Critical care), Life support care

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