TABLE 2: Surrogate Decision-makers’ Perceptions of Feeding Options at Baseline (n=255) Advantages of Assistance with Eating by Mouth:  Enjoyment of food and drink (40%)* o Pleasure and satisfaction of eating and tasting o Enjoys the taste of food o Have something to look forward to, pleasure from eating  Health and nutrition (35%) o Better varieties of food o Gets the proper nutrition o Helps keep her weight on  Effective (29%) o Could not eat if she did not get assistance o Ensures she does not eat too much and choke o The more encouraged he is the more he will eat  Dignity (20%) o Dignity of eating by mouth o It gives her a chance to be independent o Satisfaction of being self-sufficient Advantages of Tube Feeding:  Complete nutrition (53%)* o Consistently get correct amount of nutrition o Keep healthy/maintain weight o Nourish body if choking prevents normal eating  Survival (22%) o Keep person alive longer o Ensures basic survival is they cannot feed themselves o Sustain life/extend life  Other benefits (11%) o Eliminates stress of eating o Comfort for patient and family o Skin turgor maintained, less bed sores  Takes less time (7%) o Less time to feed vs. by mouth o Easier on the staff o Avoids struggle of staff/patient effort Disadvantages of Assistance with eating by Mouth:  Unpleasant experience (26%)* o Might not like the food she is given o Spill a lot/messy o Overfeeding, don’t know when to stop, have to guess  Loss of independence (19%) o Less dignified than feeding themselves o Builds dependency/discourages independence o Accelerate process of not being able to feed himself if he gets assistance- hard to change  Choking (18%) o Danger of aspiration or choking o Food may go down wrong in lungs o Can get strangled  Uncertain/lesser amount of food or drink (18%) o May not get enough nutrition o Insufficient amount of food/concerned about drinking o She’ll eat enough to subside hunger but not to maintain weight level Disadvantages of Tube Feeding:  Tube-related complications (38%)* o Infections are possible, need a lot of care to keep clean o Discomfort, having tube in you o Invasive- more risks, complications  Concern about prolonging life inappropriately (25%) o Extend life when there is no quality o May just prolong the inevitable o I believe in natural death, not prolonging life if he gets to a place he can’t digest his food normally  Less enjoyment or pleasure (22%) o Lose psychological pleasure of eating o No quality of life o Mental anguish for person- cannot eat by mouth, always thinking about food  Against prior wishes (14%) o It would go against his personal wishes o Requested that she not be tube fed o Person might not want it, against religion * percent of surrogates whose response fell within this category