Weight of practical,conceptual and ethical problems related to spoon feeding of aged patients with diminished mental capacity

This qualitative study is based on twenty observations. Problems with spoon feeding of hospitalized, elder, demented patients are rarely considered. This study aims at analyzing their practical, conceptual and ethical specificities. Ten patients were directly observed and their ten nurses of reference responded to structured interviews. We established three significant observations: 1. The use of spoon feeding appeared inoperative as it did not help resolve the problems that were invoked to justify its implementation. 2. Three months after the observations six patients were deceased, three were able to feed themselves and one did not improve. 3. In all observed cases, spoon feeding was initiated as a tacit evolution, with no formal decision process. To avoid this dead end we consider it indispensable to evolve this feeding practice from its current state of unchallengeable humane duty to the conceptual level of patient care, and to develop evaluation tools which will enable its integration into a structured strategy of nursing interventions.