Decision Aid Interventions for Family Caregivers of Persons With Advanced Dementia in Decision-Making About Feeding Options: A Scoping Review.

The review did not judge whether the included studies were methodologically strong. Only 6 publications representing 4 unique interventions were found, so the evidence base is small. The search was limited to English articles published from January 1, 2000 to June 30, 2022, and not every database was searched, so relevant studies may have been missed. Most studies used short or unstructured exposure to printed or audiovisual materials, so it is unclear how much caregiver engagement was needed. Effects on tube feeding preference and actual use were limited and inconsistent, so the aids cannot be treated as interventions that change feeding choices. Cultural adaptations were mostly surface level, such as lower reading level and updated evidence, and did not systematically address deeper cultural values or mistrust. The review focused on feeding options, but families often face multiple related end-of-life decisions.

The authors declared no conflicts of interest.

Do not conclude that decision aids reduce tube feeding use or change family preferences. The review found better knowledge and lower decisional conflict, but effects on preference and actual tube feeding were limited, and tube feeding was rare and not significantly different after 9 months.