Will your loved one end up with a feeding tube? According to an article in a recent issue of JAMA (Journal of the American Medical Association), the answer may depend more on money than on desire.

In patients with advanced dementia, doctors know that careful feeding by hand is safer and more comfortable for the patients. But because it takes more time, some nursing facilities decide to insert a feeding tube instead. Here’s the kicker–they do it even if patients had previously signed directives asking not to be tube-fed.

Hospitals were more likely to use feeding tubes if they were for-profit hospitals, or if they had a large number of patients. The authors of the study compiled a list of hospitals and feeding tube usage (view it here), so you can look up your facility. In 2003, the New York Times published an article that detailed race also plays a role: Feeding tubes are more likely to be used if the nursing home resident is black or Asian.

Both these articles clearly illustrate how some nursing homes pursue profits at the expense of our most defenseless family members. They are trading compassion and humanity for dollars. This is what we find ourselves fighting against every day.