Feeding tube use in dementia depends on state DNR rates. (NH News Notes).

Questioning the use of feeding tubes in the severely cognitively impaired to delay death or enhance quality of life, and noting the state differences, the researchers called for more consistency in medical policies governing feeding tube use.

Feeding tube use in nursing home residents with severe cognitive impairment has been shown to be associated with state-to-state differences in the use of do-not-resuscitate (DNR) orders, according to a research letter in the June 26 issue of the Journal of the American Medical Association (JAMA). In 1999, 18.1% of people with severe cognitive impairment nationwide used feeding tubes. At the state level, that rate ranged from 3.8% in Nebraska to 44.8% in Washington, D.C. For each 10-percentage-point increase in DNR order use, there was a 4.5-percentage-point decrease in feeding tube use. No such association was found with state legislative or reimbursement policies applying to feeding tube use.