In Health Watch: A new study shows many patients with end stage dementia are at an increased risk for having a feeding tube inserted while hospitalized.As Catherine Dolf explains, that decision may depend on part on which hospital they're taken to.Rosemary DeFelice (dee-feh-leece) managed to keep her Alzheimer's from her family, including daughter Cyndy, for quite awhile.Cyndy Viveiros says: "By the time it was really discovered she was fairly advanced and unable to even have these discussions."Discussions about whether she wanted a feeding tube at the end of life.Dr. Joan Teno says: "Our study shows that the decision to insert a feeding tube is more about which hospital you are admitted to, rather than decision making that elicits patient's choices and respects their wishes at the end of life."Dr. Joan Teno from brown university, led research looking at just over 163 thousand nursing home patients 66 years or older, with advanced dementia, at almost twenty eight hundred acute care hospitals with 30 or more nursing home admissions from 2000 to 2007.The study appears in this week's JAMA, Journal of the American Medical Association.Dr. Teno says: "Hospitals that were more likely to insert a feeding tube were hospitals that had a practice style of aggressive care at the end of life, they were larger hospitals and they were more likely to be for-profit hospitals."The study also shows a wide variation in the number of feeding tube insertions.Dr. Teno says: "If you were in the highest rate of using aggressive care about one in ten people had a feeding tube inserted. If you were in a hospital that was in the lowest rates of aggressive care, your rate of feeding tube insertion was only three out of a hundred."Additionally, 12 percent of the hospitals used no feeding tubes during the eight year study.