What are feeding tubes?
Tube feedings are
used to provide nutrition and medication for individuals who are unable to
swallow or who are having difficulty taking food and medication by mouth. There
are four kinds of feeding tubes: naso-gastric tubes (NG tubes), which are
inserted into the nose and down to the stomach; gastric tubes (G-tubes),
which are inserted through the skin of the abdomen and into the stomach;
jejunostomy tubes (J-tubes), which are surgically placed through the abdominal
wall into the part of the small intestine called the jejunum; and percutaneous
endoscopic gastrostomy tubes (PEG tubes), which are special G-tubes placed via
an endoscopic procedure.
What is hospice
Hospice care is end
of life care which focuses on the relief of symptoms (palliative care) and
provides emotional and social support for the dying person and for those who
care for the dying person (caregivers).
If I elect the
Medicare hospice benefit, will I be prohibited from using a feeding tube?
The Medicare statute
and regulations do not prohibit Medicare coverage of hospice care for
beneficiaries with feeding tubes, nor do they prohibit the use of feeding tubes
for people who are receiving Medicare hospice coverage. The pertinent
legal question for Medicare coverage of all hospice care is whether or not the
beneficiary has a life expectancy of six months or less if the terminal illness
runs its normal course. Thus whether or not Medicare will cover hospice
care for a terminally ill beneficiary with a feeding tube depends on the facts
of each case and specifically how use of the feeding tube will contribute to the
beneficiary’s individualized palliative care plan.
Where can I get
For more information regarding the use of tube feeding for
dying patients, go to the Hospice Foundation of America’s website at
www.hospicefoundation.org, the Family Caregiver Alliance website at
www.caregiver.org, talk to the nurses at your local hospice, and most
importantly, talk to your attending physician.