The issue of nutrition and feeding is complicated and can be fraught with significant emotional burdens. Medical ethicists draw no distinction between withholding and withdrawing ANH. The patient or his/her legally-authorized surrogate decision-maker has the right to decide whether to withhold or withdraw ANH based on medical information concerning the patient. As a result of becoming immobile, they are at much greater risk of developing painful pressure ulcers. Additionally, dementia patients may need to be physically restrained or sedated by medicine to keep them from dislodging the feeding tube. Complications from tube feeding can include pain, bloating and aspiration pneumonia, and may decrease quality of life as well as life span. In Alzheimer’s disease and dementia patients in particular, studies show that tube feeding can actually cause harm. Studies show that ANH does not extend life in patients who are near death or whose disease is so advanced they are unlikely to improve. In most instances, liquid nutrition is delivered through a tube that has been surgically inserted into the stomach or intestines, bypassing the normal digestive process that begins in the mouth. ANH can be helpful to a patient whose condition can improve or be reversed, or whose ability to swallow can be safely restored such as when surgery affects the digestive system, or if there is a blockage that prevents normal digestion. Artificial nutrition and hydration, also called ANH or tube feeding, may be offered to someone who is unable to swallow food and liquids without choking.
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