Deborah

Deborah is a sixty-eight-year-old patient with advanced dementia.  Her appetite has slowly decreased over the past two months, and had a particularly low appetite the past five days.  The care team at the nursing home has offered the option of a percutaneous endoscopic gastronomy (PEG tube) to help provide nutrients she is not getting from oral intake.  Dr. Johnson explains that the benefits are limited in this case with dementia.  He explains that the patients often try to pull out their tubes in their diminished conscious state.  Dr. Johnson leaves the decision up to her children, Robert and Ann, along with her sister Betty.  Robert and Ann agree that the feeding tube should not be placed, stating that their mother is gone, she is no longer the tough woman they know to be their mommy.  Robert states that it would be best to simply let nature take its course, if she is meant to die.  Betty is outraged at their decision.  She yells how can you let your mommy starve to death, she is a fighter would not want to die.  Betty argues that Deborah is a devout Catholic, and that her sister would have wanted the feeding tube, because she believed all life was precious.  No one can argue against Deborah’s belief that she valued all forms of life, which was clearly indicated by her strong stance of supporting pro-life movements.  However, her children still believe that the feeding tube should not be placed, because they believe their mother would be harmed more than she would benefit from the feeding tube.

            Before Deborah entered the nursing home, her children lived several hundred miles away and only got to see their mother several times a year, during holidays and birthdays.  During these times, Deborah refused to discuss her opinions about the early signs of dementia, and her health, stating she did not want to ruin the fun memories, and dampen the event.  However, Deborah and Betty have always been particularly close.  The two of them went to mass twice a week for the past ten years leading up to Deborah’s placement into the nursing home.  The past three years, while Deborah has been in the nursing home, Betty still made it a priority to visit her sister several times a week, especially on Thursday nights for bingo.  Betty also has seen how much Deborah has enjoyed the programs the nursing home puts on during the week, along with spending time with her friends at the nursing home.  Should Dr. Johnson place the feeding tube?

--Written by Amanda Zinger