This is part of the article series in Tube Feeding due to Alzheimer's/dementia/dysphagia Resource page.
I am grateful that we are in Thailand and sought medical care from doctors here. When my mom developed difficulty swallowing due to late stage Alzheimer’s, all the doctors here recommended nose tube intubation (nasogastric tube).
My mom survived and recovered her energy from nose tube feeding. Even my family and her friends back in Malaysia agreed that the healthcare and support system we get here is excellent. Had she been in Malaysia or elsewhere, she probably would not have made it.
As expected, Alzheimer’s patients would definitely attempt to pull off the nose tube due to discomfort. There is no way we can reason with them not to do it. And the pulling and reinserting may result in trauma to the nose and throat passageways. Not to mention frustration and exhaustion for the caregiver to take the person to the hospital or ER for reinsertion.
One of the important key to prevent them from pulling out the tube is a proper hand mitten or restraints. When thinking of hand restraints, scary pictures of elderly strapped on their beds begging for mercy may be conjured up in your mind.
I want to assure you, from my experience with my dear mother, it is NOT the case. I was very fortunate to be able to purchase a very good hand mitten/restraint from one of the main pharmacy in Bangkok.
I have never seen anything like it. Please note we cannot use ordinary winter mittens or a cover because they can still bend their hands to pull the tube. The hand restraint must be unyielding, ie it does not bend when the fingers bend. If it does, then the mittens can wrap around the nose tube and tug it out.
At the same time, because it is being worn long term and the whole day, it cannot be warm or uncomfortable.
Below is the mitten I had bought. I got 2 pairs (so that I have one set to use when I wash one set). It is real fortunate and I want to bring to your knowledge that such products exist:
If you look at the mitten, the internal is unyielding and retains its shape. There is strong netting material at the side and in the front for ventilation. There is also a small sewn hook on the side for the option to tie to the bed railing (for Alzheimer’s patients on tube feeding, you would need to purchase a hospital bed to incline them during feeding and with safety railings).
My mother is on her 3rd month into tube feeding. She had sort of gotten used to the nose tube but still tries to rub her nose and pull down the tube often, with her hand mittens. I secure her tube with the nose tape which I change often.
Within a few weeks of wearing it, she has also gotten used to her ‘new hands’ with the mittens or restraints. She would often look at the mittens puzzledly, then play with her ‘hand’ by clapping them together.
I no longer need to tie the mittens to the bed railings via the side hook on the mitten. She can move her hands as how she like to do it but the only difference now her hands are securely covered. In her stage of Alzheimer’s she is not in distress due to the hand cover or mittens, contrary to what people logically think.
Washing of the hand mittens
I removed the mittens, one hand at a time to wash each hand with soap and water, then dry up with a towel before putting the mitten back through tying the opening at her wrist with the string. Her hand does not feel warm or uncomfortable. Usually, I would wash the mitten once every 4 or 5 days as it does not smell since we are in air conditioned room almost the whole day. That is why when purchasing we always need to get 2 sets.
The mittens, even though looked thick, do not take a long time to dry. I wash by hand because I do not want to risk the nettings on the mittens being entangled with anything and breaking off. Then I spin the mittens in the spinner of my washing machine.
This hand restraint for elderly is really one of its kind
I have tried to check out sites like Shopee and Amazon and could not find any products even close to this one that my mom is using.
Curious, I called up the number that came in the brochure (written in Thai) via the Line app. I spoke to Mr Songwut. First thing I asked him if he could speak English. He modestly told me he could speak a little but it turns out his English is much more proficient than my spoken Thai so in the end wr spoke in English.
This product is something he designed and commissioned it to be make himself hence it could not be found elsewhere. He wanted to provide something comfortable for the elderly or patients to use if hand restraints are required.
In fact, he happened to only supply to one phamarcy in Bangkok and so happened it was the same pharmacy we often got our medical supplies.
I really feel with a comfortable hand mitten that does not distress the person, phlegm suction care (if the patient no longer can swallow or spit out mucus and phelgm), the person with end stage Alzheimer’s would be able to lead a better quality of life.
Seriously, all doctors and specialists that I have seen in Thailand recommend nose tube feeding once the Alzheimer’s or dementia patient could no longer consume adequetely on their own. The idea, practiced in some countries to just ‘let nature takes its course’ is totally inconceivable here where love and care for elderly and parents are highly valued.
Most of the time, their digestion system is working fine. They can still digest food, absorb nutrients and eliminate waste. The only thing is the throat is not able to deliver the food to the digestive system. Medical perform intervention even when there is no cure so how could we let someone whose system is still capable of digesting and absorbing nutrients literally starve to death?
Information on the Hand restraints/ mittens
If you wish to find further information on the hand restraints and mittens, you may refer to the following information:
Note: The facebook page contains videos on how to use the hand restraints and what it is made off.
Name: Maysa Medical
Facebook page: https://www.facebook.com/Maysamedical/
Tel number (contactable via Line app for free) : +66956241956
This is their brochure information:
They also have another product which is a hand restraint leaving the hands open. It is padded hence it is comfortable and resillient:
I understand they can arrange to ship it to overseas buyers.
Alternatively, you may try out to make your own DIY hand mittens: