Home > Blogs > Nutrition > What is Home Enteral Nutrition?

What is Home Enteral Nutrition?

Nutrition Despina Moshopoulos
What is Home Enteral Nutrition?

What is Home Enteral Nutrition?

Enteral nutrition is a method of nutrition that enters directly into the gastrointestinal tract, avoiding the mouth and esophagus. This form of feeding is used when a person can’t consume enough nutrients orally but still has a functioning digestive system. Through the enteral feeding tube, a specialised liquid that contains all the essential nutrients is delivered directly into the stomach or small intestine. Home enteral nutrition (HEN) specifically occurs in the home and can create some challenges due to a combination of medical and logistical factors. 

Across Australia, there are more than 15,000 people who rely on HEN for their essential nutrition, hydration and medication delivery every day. It can be hard for caregivers to manage HEN because of the potential complications that may arise and being able to provide adequate education and support. Carers also have to navigate funding and supply issues as well as the psychological impacts that HEN may have on your client, friends and family.

Support and Funding in Australia

HEN programs are typically coordinated by state and territory public health services in partnership with specialist dietitians and clinical teams. Once a patient is medically assessed and deemed to require enteral nutrition, they are referred to their local HEN service.

The program provides:

  • Access to enteral feeding products: Including nutritional formulas, feeding pumps, tubing, syringes, and other consumables.

  • Clinical support: Ongoing dietetic and nursing support to monitor nutritional status, manage complications, and adjust feeding regimens as needed.

  • Home delivery: Many states offer delivery services for feeding products directly to patients’ homes for convenience.

Eligibility and Funding

Eligibility criteria vary by state but generally include patients with chronic or long-term medical conditions requiring tube feeding who are living at home or in community care settings.

Funding for HEN products and services is often provided through public health programs, sometimes in partnership with private suppliers. The program also supports carers and family members through education and training in tube feeding techniques and care.

Benefits of the HEN Program

  • Enables safe and effective nutritional support in the patient’s home environment.

  • Reduces hospital admissions and length of stay.

  • Supports independence and comfort for patients and carers.

  • Provides multidisciplinary care tailored to individual needs.

State-Specific Programs

Each Australian state and territory manages its own HEN program with slight variations in eligibility, funding, and service delivery:

  • NSW: EnableNSW program supports access to enteral feeding equipment and clinical services.

  • Victoria: Offers home-delivered enteral nutrition funding through public health services.

  • Queensland, Western Australia, South Australia, Tasmania, Northern Territory: Similar state-managed programs exist, offering product supply and clinical support.

Who Needs Home Enteral Nutrition?

There are over 300 medical conditions that require feeding through tubes making it essential for caregivers to understand what they are and how they function. The most common reason people need HEN is those with dysphagia or difficulty swallowing. Dysphagia is caused by a range of different conditions like stroke, head or neck cancers or neurological disorders that make swallowing painful or difficult. HEN allows those people who are unable to consume food or liquids to adequately absorb the correct amount of nutrients.

Types of Enteral Feeding Tubes

There are three main types of feeding tubes, classified by their point of insertion. Despite their different placements, all are designed to serve the same purpose: delivering the proper amount of nutrients to the user.

Nasogastric Tube (NG)

An NG tube is a flexible tube inserted through the nose, down the esophagus, and into the stomach. It is typically used for short-term enteral feeding.

Gastronomy Tube (G)

A G tube is inserted directly into the stomach through the abdominal wall and is intended for long-term feeding.

Jejunostomy Tube (J)

A J tube is inserted into the jejunum, a part of the small intestine, through the abdominal wall. It is used when feeding through the stomach isn't an option or when there is a risk of aspiration.

How Does Home Enteral Nutrition Work?

The process of starting HEN begins with a referral from a healthcare professional — this may be a doctor, dietitian, or nurse. A specialist, typically a gastroenterologist or surgeon, will assess the patient’s medical condition and determine the most appropriate type of feeding tube. The choice of tube depends on the expected duration of HEN and the individual's medical and nutritional needs.

Once the feeding tube is inserted, comprehensive training is provided to both the patient and their caregivers before discharge from hospital. This education includes tube care and site hygiene, administering feeds and medications safely, and recognising early signs of complications such as infection, leakage, or tube blockage. This training ensures that carers are confident and equipped to manage HEN in the home environment.

At home, daily responsibilities include monitoring the stoma site for redness, swelling, discharge, or other signs of infection. Caregivers must also ensure that the correct volume of formula and medications are administered according to the feeding schedule. It’s crucial to flush the feeding tube with sterile or cooled, boiled water before and after feedings and medication delivery to prevent blockages.

Ongoing monitoring by healthcare professionals—particularly Accredited Practising Dietitians (APDs) — is a core part of the HEN process. These reviews help ensure that nutritional goals are being met, the formula remains suitable, and any medical or mechanical issues are promptly addressed. Regular follow-up may include weight checks, blood tests, and assessments of gastrointestinal tolerance to feeding. This ongoing support is essential for safe, long-term nutrition management at home.

Caregivers play a critical role in this process. By adhering to care plans and being vigilant about hygiene and complications, they ensure that the person receiving HEN continues to get the nutritional support they need to stay well at home. When issues such as vomiting, tube dislodgement, or infection arise, it's important that caregivers know when to escalate care and contact medical professionals.

Tips for Successfully Managing Home Enteral Nutrition

Proper care and maintenance of feeding tubes are essential for successfully managing HEN at home. Caregivers should clean the tube site daily using warm water and mild soap, ensuring the area is completely dry to prevent infections. Regular flushing of the tube with sterile or cooled boiled water before and after feeds, medications, and every few hours during continuous feeding helps keep the tube clear and functioning properly. 

When administering medications, it’s important not to crush tablets unless advised, and liquid forms should be used whenever possible, with flushing before and after each medication to avoid blockages. For gastrostomy tubes, gently rotating the external fixation device daily, if recommended by healthcare professionals, can prevent skin breakdown and pressure sores. 

Caregivers should also vigilantly monitor for signs of complications such as leakage, dislodgement, or gastrointestinal upset, and keep a detailed log of feeds, flushes, medications, and any concerns. This log aids in ongoing medical reviews and helps catch potential issues early, ensuring the person receiving HEN gets the safest and most effective nutrition support possible.

Benefits and Challenges of Home Enteral Nutrition

HEN can offer significant benefits for both care recipients and their carers, but it also comes with challenges that are important to acknowledge. For carers, one of the biggest advantages is the ability to support a loved one’s nutritional needs in the comfort and familiarity of home, reducing the need for extended hospital stays and improving quality of life. HEN also allows for greater independence and can contribute to better long-term health outcomes when managed well. 

However, it can be demanding — learning how to care for feeding tubes, administer feeds, and monitor for complications requires training, confidence, and ongoing support. Carers may also face emotional and physical stress, especially when juggling other responsibilities. Accessing reliable equipment, coordinating healthcare appointments, and navigating funding systems like the NDIS or state HEN programs can add extra pressure. Despite these challenges, with proper education, regular healthcare support, and the right funding in place, carers play a vital role in making HEN safe, effective, and sustainable at home.

Conclusion

HEN is a vital lifeline for thousands of Australians who cannot meet their nutritional needs through regular eating but still have a functioning digestive system. While it enables individuals to receive essential nourishment in the comfort of their own homes, it also places considerable responsibility on caregivers. From daily care routines to monitoring for complications and navigating funding systems, the role of the carer is both crucial and complex. Fortunately, Australia has well-established HEN programs, clinical support, and funding avenues such as EnableNSW, state-run health services, and the NDIS to assist families in managing these challenges. With the right training, support, and collaboration with healthcare professionals, HEN can be a safe, effective, and empowering solution for people living with chronic health conditions. By understanding how HEN works and being prepared for its demands, caregivers can help ensure their loved ones receive the nutrition they need to thrive at home.

Explore Our Range of Enteral Feeding Nutrition Supplies

Sources

Dietitians Australia. (2025, July 22). Enteral nutrition. Retrieved July 22, 2025, from https://dietitiansaustralia.org.au/health-advice/enteral-nutrition

WA Country Health Service. (n.d.). Funded Home Enteral Nutrition Program Procedure. Retrieved July 23, 2025, from https://www.wacountry.health.wa.gov.au/~/media/WACHS/Documents/About-us/Policies/Funded-Home-Enteral-Nutrition-Program-Procedure.pdf

Queensland Health. (n.d.). Guideline for Home Enteral Nutrition Service (HENS) for Outpatients. Retrieved July 22, 2025, from https://www.health.qld.gov.au/system-governance/policies-standards/guidelines/guideline-for-home-enteral-nutrition-service-hens-for-outpatients

NSW Agency for Clinical Innovation. (n.d.). Home enteral formula and equipment. Retrieved July 23, 2025, from https://aci.health.nsw.gov.au/networks/nutrition/resources/home-enteral-formula-and-equipment

Victorian Department of Health. (n.d.). HEN and TPN: Home delivered funding arrangements for Victorian public health services. Retrieved July 21, 2025, from https://www.health.vic.gov.au/publications/hen-and-tpn-home-delivered-funding-arrangements-for-victorian-public-health-services

Queensland Health. (n.d.). High Performance Health Environment (HPHE): Gastrostomy tube fact sheet. Retrieved July 22, 2025, from https://www.health.qld.gov.au/__data/assets/pdf_file/0026/154682/hphe_gastrostomytube.pdf

National Association for Home Care & Hospice (NAHC). (n.d.). Feasibility and clinical utility of a remote monitoring model of care for patients on home enteral nutrition. Retrieved July 23, 2025, from https://nahc.com.au/feasibility-and-clinical-utility-of-a-remote-monitoring-model-of-care-for-patients-on-home-enteral-nutrition/

Tags: Nutrition