Original Research

South African speech-language therapists’ practices regarding feeding tube placement in people with advanced dementia

Mariaan Cloete, Esedra Krüger, Jeannie van der Linde, Marien A. Graham, Sarveshvari B. Pillay
South African Journal of Communication Disorders | Vol 69, No 1 | a927 | DOI: https://doi.org/10.4102/sajcd.v69i1.927 | © 2022 Mariaan Cloete, Esedra Krüger, Jeannie van der Linde, Marien A. Graham, Sarveshvari B. Pillay | This work is licensed under CC Attribution 4.0
Submitted: 09 February 2022 | Published: 09 December 2022

About the author(s)

Mariaan Cloete, Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
Esedra Krüger, Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
Jeannie van der Linde, Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
Marien A. Graham, Department of Science, Mathematics and Technology Education, Faculty of Education, University of Pretoria, Pretoria, South Africa
Sarveshvari B. Pillay, Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa


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Abstract

Background: Studies related to tube feeding in people with dementia (PWD) remain a contested topic, neglecting the importance of speech-language therapists’ (SLTs) role in dysphagia management. Furthermore, SLT practices and beliefs regarding tube feeding in people with advanced dementia in an upper-middle-income country, such as South Africa, are unexplored.

Objective: This study aimed to determine the practices and beliefs of SLTs in South Africa regarding tube feeding placement in PWD.

Method: A self-compiled online survey was distributed using social media platforms and was completed by 83 South African SLTs with experience in swallowing and feeding management of PWD.

Results: Most SLTs (78.8%) strongly believed they play a vital role in the decision-making regarding feeding tube insertion in PWD. This role is often met with several challenges, such as limited support from other healthcare professionals. Speech-language therapists with more experience and increased involvement in palliative care appeared to be more confident in supporting and counselling families of PWD on tube feeding. Many SLTs still recommend tube feeding despite its known negative consequences for PWD.

Conclusion: The findings indicate a need for continued professional development for South African SLTs on feeding decisions in advanced dementia to increase knowledge and confidence in clinical practice. Speech-language therapists require guidelines by professional bodies and further dialogue amongst healthcare professionals to guide difficult feeding decisions in people with advanced dementia.


Keywords

tube feeding; advanced dementia; speech-language therapists; dysphagia; beliefs; practices; South Africa; electronic survey

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