FAMILY COMMUNICATION AND DECISION-MAKING - Feeding Options for Chinese American Persons With Advanced Dementia

Sep 29, 2026

Feeding difficulties commonly emerge as dementia advances, yet feeding tubes provide no clinical benefit while remaining widely used among Asian communities, including Chinese Americans. A qualitative descriptive study explored how family communication shaped feeding choices among 21 caregivers of Chinese American individuals with advanced dementia. Semi-structured interviews and thematic analysis examined cultural values, family dynamics, and healthcare interactions influencing collective decision-making, deference to clinicians and elders, and challenges driven by conflicting perspectives, emotional distress, and uncertainty without advance directives.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background

Feeding tube use and dementia progression

Study Methods

Qualitative descriptive design

Semi-structured interviews and thematic analysis

Findings

Collective decision-making and deference

Family dynamics, uncertainty, and emotional distress

Implications

Culturally tailored support and improved provider-family communication

Innovation in Aging, 2025, Vol. 9, No. S2 333 about nutrition, prolonging life, and filial piety drive many families toward feeding tube insertion, even when caregivers express doubts. External pressures from healthcare providers and cultural expectations can further complicate decision-making. However, open family communication, shared values, and mutual understanding facilitated more cohesive decision-making, allowing families to align feeding choices with the perceived wishes of their loved ones. These findings underscore the critical need for culturally tailored decision-making support, early discussion of feeding preferences, and improved provider-family communication. Strengthening communication pathways within families and between families and healthcare providers can empower caregivers, reduce unnecessary feeding tube use, and enhance end-of-life care experiences for Chinese American families navigating advanced dementia care. Abstract citation ID: igaf122.1125 FAMILY COMMUNICATION AND DECISION-MAKING IN FEEDING OPTIONS FOR CHINESE AMERICAN PERSONS WITH ADVANCED DEMENTIA Jing Wang1, Jing Huang2, Bei Wu3, Laura Hanson4, Dena Schulman-Green5, and Yaolin Pei6, 1. University of New Hampshire, Durham, New Hampshire, United States, 2. Johns Hopkins University, Baltimore, Maryland, United States, 3. NYU Shanghai, Shanghai, China (People’s Republic), 4. The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States, 5. New York University, New York, New York, United States, 6. The University of Texas at Austin, Austin, Texas, United States Feeding difficulties commonly arise as dementia progresses to its advanced stages. Although research consistently shows that feeding tubes offer no clinical advantage, they continue to be widely used among Asian populations, particularly within the Chinese American community. This study employed a qualitative descriptive design to examine examines how family communication shaped feeding choices among 21 caregivers of Chinese American individuals with advanced dementia. Using semi-structured interviews, data were analyzed thematically to examine the influence of cultural values, family dynamics, and healthcare interactions in shaping feeding decisions. Findings highlight that feeding decisions are often made collectively, with strong deference to medical professionals and elder family members. Caregivers frequently struggle with navigating differing family perspectives, emotional distress, and decisional uncertainty, particularly in the absence of advance directives. Concerns

FAQs

Why are feeding tubes still commonly used for Chinese American persons with advanced dementia?

Feeding difficulties often increase as dementia progresses, and despite evidence showing no clinical advantage, feeding tubes remain widely used in Asian populations, including the Chinese American community.

How did the study examine family influence on feeding choices?

The study used a qualitative descriptive design with semi-structured interviews of 21 caregivers, followed by thematic analysis to assess the roles of cultural values, family dynamics, and healthcare interactions.

What main challenges did caregivers face during feeding decisions?

Caregivers often navigated differing family perspectives, emotional distress, and decisional uncertainty, especially when advance directives were absent.

Sep 29, 2026

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