New York Times (August 2, 2010): Feeding Dementia Patients with Dignity

Publication Date: 
Mon, 08/02/2010

First Alzheimer's disease stole Rosemary DeFelice’s speech, mobility and independence. Then, at 75, she lost the ability to eat.

She would chew away at her food, coughing and sputtering and spitting up but swallowing very little, said her daughter, Cyndy Viveiros. And like many relatives caring for patients with advanced dementia, Ms. Viveiros had to decide whether or not to have a gastric feeding tube inserted.

This quandary — which usually arises near the end, when Alzheimer’s begins to destroy the part of the brain that controls eating — is often presented as a stark choice between providing nourishment and withholding it.

But social workers advising Ms. Viveiros suggested another option: continuing to have her mother carefully fed by hand, giving her only as much as she wanted and stopping if she started choking or became agitated.

“I had this realization — wow — that no matter what we did, Mom was never going to get better,” Ms. Viveiros said. “We were just prolonging the inevitable, and potentially causing more suffering.

“Mom was already dying. Alzheimer’s is a terminal disease. There’s no stopping it,” she said.

Mrs. DeFelice, of Providence, R.I., died about eight months later.

Doctors are calling this new option in palliative care “comfort feeding only.”