Food has a calming effect on us. Breastfeeding or bottle-feeding is a special time for moms and their babies to get close. When a family member or friend is sick in bed with a cold, we bring them chicken soup.
Cultural events and festivals aren’t the same without the accompanying feasts. Celebratory ice cream with a brightly iced cake. Traditional Thanksgiving fare includes a turkey dinner with all the fixings. Christmastime is for ham in a spiral, pecan pie, and sugar cookies. Hanukkah treats: and livivot. Fourth of July barbecue with burgers, hot dogs, and chilly watermelon. The list is endless. That’s how we’ve demonstrated our love for our loved ones for decades. However, eating habits shift significantly throughout the final stages of life.
As a hospice nurse with 20 years of experience, I know that the most pressing concerns for the loved ones of our hospice patients are “I don’t want mom to starve” and “I want to get some fluids into dad.”
To go personal: I lost my mom four years ago. Due to her prolonged illness, she was transferred to a hospice in a rural area. It had been five days since she had eaten or drunk anything. When she passed away, my siblings and I were by her side. I had a hard time deciding whether or not to force food or fluids at the moment of death, even though I was aware of the clinical implications.
On a more emotional level, it’s tough to consider the possibility that we’re letting our loved ones go hungry or thirsty. Many caregivers wonder, “Will I feel bad about this when it’s all over?”
Late feeding or hydration administration might harm a dying loved one in a clinical setting.
The body loses its ability to manage fluids as it nears death properly. Significant symptoms can develop from fluid imbalances:
Swelling, known as edema, can affect any part of the body, including the feet, legs, and hands. This can hinder the body’s ability to heal from injuries and fight off infections. And the worst part is that it can lead to lung enlargement. “Pulmonary edema” describes this condition.
Some signs of pulmonary edema are breathing difficulties, coughing, and even hypoxia (not enough oxygen in the blood). In severe cases of hypoxia, family members may become hostile and violent. Skin tones can change to a bluish hue for certain people.
Fluids are a potential issue, but they are not the only ones.
Providing for our families’ nutritional needs during this time might be just as challenging. If someone is forced to eat, they may choke or aspirate their food. As the name suggests, this is when someone takes in liquids or solids into their lungs. It hurts when this happens. It can bring on similar symptoms, like breathlessness and coughing. Some of our loved ones may feel ill after eating at this time, and we may have gastrointestinal distress in the form of nauseous vomiting, bloating, gas, constipation, or diarrhea.
Someone who is nearing death may find this very distressing. Try to put yourself in the position of someone who is otherwise perfectly healthy and experiencing the discomfort of nausea or bloating. It’s considerably worse for the dying individual.
Those providing care for the patient need not fear that their patient is going hungry or thirsty. What’s the explanation? In a nutshell, the human body is incredible. In its final days, it has learned to cut back on its consumption of food and water until it is no longer necessary. The dying process has begun, and the body is shutting down.
So, even though we typically use food to soothe our loved ones, forcing them to eat or drink won’t help. That will only make their problems worse. No matter how challenging it may be, there may come a point when we must find fresh approaches to bringing peace and calm to our loved ones. Talk to their hospice nurse or another healthcare provider if you have questions about when to cease giving your loved one food and water. Despite how challenging it may be for you, remember that this is the most meaningful gesture of your love.
The requirements for sustenance and hydration of a dying patient are very different from those of a healthy, energetic one. A person’s capacity to digest and assimilate meals and liquids declines with time as death approaches. There may be a requirement for only minimal amounts of nutrients or hydration/liquids as organs and body processes cease.
Artificial nutrition and hydration (ANH), including nasogastric (NG) or percutaneous (PEG) feeding tubes or intravenous (IV) fluids for hydration, might prolong the dying process and cause various health complications.
A discussion about artificial nourishment and hydration is always included in the tailored care plans MelodiaCare Hospice creates in collaboration with patients and their families to honor the patient’s choices and values.
How Loved Ones and Caregivers Can Be of Assistance
At the end of life, patient preference should play a pivotal role in determining the course of nutrition and hydration. Patients who value comfort at the end of life often request to be free of tubes and other medical devices so they can be near their loved ones and receive the reassurance they need in their final moments.
- Support from family and carers is crucial during the final stages of life.
If the patient can still consume liquids or solids, provide extremely few spoonfuls of food, such as ice chips, hard candy, or very small portions of meals. Listen to the patient’s cues about when to stop.
If the patient cannot drink, use wet washcloths, swabs, lip balm, or moisturizers to keep the lips and mouth moist.
Suppose the patient is unable or unable to eat. In that case, various forms of sustenance such as conversation, touch, music, singing, poetry, humor, pet visits, gentle massage, reading, prayers, and other acts of caring and love can help.
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