Oregon law requires Alzheimer's patient be spoon-fed despite advance directive
Despite having signed an advance directive drawn up by a lawyer to limit attempts to prolong her life if she became incapacitated, an Oregon woman suffering early onset Alzheimer’s disease is being spoon-fed at a nursing home, the Mail Tribune newspaper of Medford, Oregon reports.
When Bill Harris, of Ashland, Oregon, sued to stop the spoon-feeding, the State Long-Term Care Ombudsman Office opposed the challenge, saying the nursing facility must help his wife Nora Harris eat.
Oregon Administrative Rules for nursing homes say the facilities must provide three nutritious, palatable meals and snacks daily. They also must provide “assistance with eating (e.g. supervision of eating, cueing, or the use of special utensils).”
Cueing is defined as verbal or visual clues to help with daily activities. Harris and his lawyer, Jason Broesder, argue that Nora Harris is simply responding reflexively to a spoon held to her mouth.
The advance directive, as is typical, specified only “artificial nutrition” and hydration, not regular food fed by spoon.
Nora Harris, 63, was diagnosed with Alzheimer’s disease in 2009 and now can eat only when prompted by someone feeding her, according to Bill Harris. A volunteer ombudsman at the Fern Gardens nursing home had directed staff there to spoon-feed her after seeing her with a sandwich in her hand when others were eating a prepared meal.
Jackson County Circuit Judge Patricia Crain said in court that she could not order the spoon-feeding stopped because the ombudsman’s office says it would violate the law.
“It’s not a happy decision for me,” Judge Crain told Bill Harris and his daughter. “From what you describe of your wife and your mom, she would hate this. She would hate it.”
The judge noted that Nora Harris is in effect being forced to eat, though food is not being shoved into her mouth.
The case has highlighted the issue of spoon-feeding for experts in preparing advance directives. Broesder says he has begun addressing it in discussions of advance directives with clients.
“I tell clients, ‘You need to think about this. If you would not want to be spoon-fed, you need to specifically include that. The state forces you to be spoon-fed when you can no longer think or communicate for yourself,’” Broesder says.
But that might require changes in the law.
“It’s an open legal question that might have to play out with the courts or the legislature,” said Fred Steele, agency director of the ombudsman office, which is charged with protecting the rights of those in long-term care.
