Dementia is not a disease, but rather a collection of symptoms stemming from brain deterioration that occurs as people age. Alzheimer’s disease and small repetitive strokes known as vascular dementia are the most common illnesses leading to dementia.

The Alzheimer’s Association estimates that 16 million Americans will have Alzheimer’s by 2050. About 5.4 million have the disease now.

Demented patients often have severe memory or language problems. Most types of dementia are irreversible, according to the National Institute of Neurological Disorders and Stroke, though some symptoms can be managed with drugs.

By 1996, according to a study in the Journal of General Internal Medicine, patients with dementia made up the single largest category of U.S. patients receiving PEG tubes.

As early as 1999, gerontologists from Johns Hopkins Medical Center, writing in the Journal of the American Medical Association, advocated: “The widespread practice of tube feeding should be carefully reconsidered, and we believe that for severely demented patients the practice should be discouraged on clinical grounds.” A 2000 article in the New England Journal of Medicine came to the same conclusion.

Yet in 2008, two Harvard Medical School physicians, writing in the Journal of the American Medical Directors Association, were still questioning why PEG tubes remained “commonplace” among patients with advanced dementia despite a consensus among neurologists, geriatricians and ethicists against such customary use.

(Gabe Gao is a December 2011 graduate of the University of Iowa’s Master of Arts in journalism program and is now a medical student at Northwestern University)

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