• end-of-life decision-making;
  • ethics;
  • feeding tube;
  • long-term care;
  • qualitative study

Aim.  To develop a broad understanding of nursing beliefs, knowledge and roles in feeding decisions for nursing home residents with advanced dementia.

Background.  Concern is growing about the common use of feeding tubes in nursing home residents with advanced dementia. Nurses can play an important role in providing information and guiding family members through difficult feeding decisions. Little is known about nurses’ perspectives on feeding decisions.

Design.  Qualitative descriptive.

Methods.  In-depth semi-structured interviews of 11 licensed nurses who were experienced in caring for nursing home residents with dementia.

Results.  Analysis of the interview transcripts revealed three themes: insufficient empirical information, ambiguous role in feeding decisions and uncertainty about moral agency in decisions about the placement of feeding tubes.

Conclusions.  Despite views that family members would benefit from guidance in decisions regarding the placement of feeding tubes, nurses were, nevertheless, reluctant to become involved in these difficult decisions.

Relevance to clinical practice.  If nurses are to guide family members in decisions about the use of feeding tubes, they need more education about evidence-based practice as well as support in exercising their nursing responsibilities.