South African speech-language therapists' practices regarding feeding tube placement in people with advanced dementia.
Mariaan Cloete, Esedra Krüger, Jeannie Van der Linde and 2 others
PMID 36546518WHAT IT FOUND
Most South African speech therapists surveyed would recommend tube feeding to a family member with advanced dementia, despite evidence it does not improve quality of life.
They cited family pressure and a lack of local guidelines as the main drivers of this decision.
Key findings
01More than half of the surveyed speech therapists believed tube feeding was the most viable option for people with advanced dementia and would recommend it to a family member.
02The most frequently reported challenges in tube feeding decisions were family members' cultural values and perceptions, followed by the therapist's own bio-ethical concerns.
03Nearly nine in ten respondents stated they wanted to learn more about managing feeding and swallowing in dementia, identifying a clear gap in current professional development resources.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was recruited via social media and professional networks, which may bias results toward therapists with a specific interest in this topic. Most respondents worked in the private sector, so the findings may not reflect the realities of public healthcare settings in South Africa. The study reports self-reported practices and beliefs, not actual clinical outcomes or patient data. Response rates dropped significantly for older questions, leading to missing data in some analyses.
Declared interests
The text does not specify funding sources or conflicts of interest declarations.
The easy way to misread this
Do not interpret the therapists' preference for tube feeding as evidence that it is clinically effective. The paper explicitly states that tube feeding has been shown not to improve quality of life or comfort in end-of-life care, yet most respondents still favoured it due to family pressure and a lack of guidelines.