Ending Life Well: Conversations & Connections
By McKenna Reinhard , End of Life Specialist Nutrition at End of Life While it can be distressing to witness, it isn’t unusual for individuals at the end of their life to lose interest in eating and drinking. For those around them, seeing a loved one lose weight and imagining the discomfort they must be in (because we know how we feel when we’re hungry or thirsty) can make this a really difficult situation. In these cases, loved ones often want information about artificial nutrition and hydration to see if this is something that may benefit their loved one. While this isn’t medical advice, hopefully it can serve as a starting point for conversations with a medical provider if you want to talk to them about this topic. Artificial nutrition and hydration involves placing tubes, whether temporarily or permanently, to provide someone with hydration and/ or nutrition when they are unable to take these in on their own by mouth. These are not only used in end of life scenarios; individuals may need artificial nutrition and/or hydration after surgery, due to trauma, due to cancer, or for several other reasons. There are several ways someone may get artificial nutrition and hydration including intravenous fluids, nasogastric tube, or PEG tube and many factors go into the decision including how long they are estimated to need the assistance for. Artificial nutrition and hydration can
be very beneficial to those who need it while recovering from a temporary or short-term problem. However, it might make less sense for someone nearing the end of their life. One reason that it may not make sense to use artificial nutrition and hydration at the end of life is because a lack of interest in food and fluid is actually a normal part of the dying process in many cases. As the body and organs start to shut down and function at lower levels, they need less energy to function than they did before. Additionally, while the interventions for artificial nutrition and hydration may be minimally invasive, they are still medical interventions that come with risks and possible complications (which vary depending on the route used). These include sepsis, aspiration, pressure sores, skin breakdowns, and complications due to fluid overload.
While the goal of these interventions is to relieve suffering, there is a chance that they may cause the dying person more discomfort. It is important to weigh the risks and benefits with the healthcare team to determine the best course of action for each individual. As with all end of life matters, there is no one right answer to the question of artificial nutrition and hydration at the end of life. If you know what you want for yourself, make sure you document it in your advance directives and discuss it with your loved ones.
If you need more information on completing your advance directives, call our Helpline at (520) 790-7262 to get connected with one of our End of Life Specialists.
March 2023, Never Too Late | Page 27
Pima Council on Aging
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