The practice and attitude of nursing home workers towards decision making of gastrostomy for the elderly

Abstract

  Although indication of gastrostomy feeding for the elderly is one of the common issues of clinical ethics in nursing homes, nursing home workers’ practice and attitude regarding shared decision making with patients and their families about starting gastrostomy feeding have not been elucidated. Thus, we conducted a self-completed questionnaire survey of 4 intensive care homes for the elderly and 1 long-term care health facility in Japan. Sixty-seven nursing home workers participated in the survey. Most Japanese nursing home workers did not have experience to discuss with patients and their families in decision making about starting gastrostomy feeding and were not willing to play a role in the process. The workers’ thought that the decision should be made by medical staffs and families, and the workers’ negative impression about gastrostomy feeding seemed to underlie the results. On the other hand, some of the workers recognized that they should confirm the patients’ own preference. These findings suggest that ethical support and education may be necessary in nursing homes in Japan.