Mdm N is an 80-year-old Chinese female with advanced Parkinson’s Disease (PD) and vascular dementia (VaD) who was admitted to a community hospital for management of her sacral ulcer. She was bed-bound and non-communicative and had been initiated on nasogastric tube (NGT) feeding since 2009. Over her prolonged inpatient stay for wound care, numerous difficulties were encountered in her NGT feeding requiring frequent adjustment of her feeding regime. This led to difficulties with her long-term placement even after her sacral ulcer had healed. Through this case, we illustrate the challenges encountered in patients on long-term tube feeding (TF), measures that were taken to optimise her nutrition and how these challenges had a bearing on her long-term care.