During my father's end stage Alzheimer's he had open heart surgery which then three months later led to internal bleeding and resulted in stomach surgery which left him with a temporary feeding tube. I felt this was all ridiculous since he was 82 and in end stage Alz but not my decisions. The temp feeding tube meant he should not eat while his stomach healed - sure, tell that to a dementia patient. He was also given a swallowing test and we were told not to let him eat that he would choke besides the stomach problem. My dad constantly pulled the tube out...well, a long story. He was eating everything and occasionally choking. The stomach surgeon was disgustingly unavailable and nasty. I eventually took my dad to a gastroenterologist who was very kind and asked why we were there. I wanted to know if we removed the feeding tube along with his swallowing problem, what would happen. He told us that eating was an important thing to my dad obviously and if it were his dad he'd remove the feeding tube, let him eat and if he ate and aspirated, the risk was high he would die of pneumonia but at least he would have been happy. That it would just shorten his life. He also explained as the expert said here that swallowing issues were a common issue at this stage of Alz. He told us to let him live his life. We took the tube out and let dad eat what he wanted. In the end he died of natural causes at 84. The nursing home kept suggesting more swallowing tests and even speech therapy which we refused.
I think, personally, hate to say it, there is money involved in running tests, speech therapy(really? for a dementia patient is ridiculous) and doctors/facilities worry about risk of lawsuits when tests aren't run. It means the caregiver has to get a lot of information and stand firm on the care you want and reasons for it. Not easy but better for the patient.