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.
