Food at End of Life
Grane Hospice
For more information about the author, click to view their website: https://granehomehealthandhospice.com/locations/pittsburgh-pa/
Nov 07, 2024
Pennsylvania - Greater Pittsburgh Area
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A Delicate Dance: Discussing Food and Comfort at the End
of Life
For referral partners transitioning patients to hospice
care, a common source of tension arises: the practice of regular solid food
feeding. Families, often driven by love and cultural norms, may struggle to
accept that forced feeding can be detrimental to their loved one’s comfort in
the final stages of life. This article equips medical professionals with
talking points to navigate these sensitive conversations, prioritizing the
patient’s well-being while acknowledging familial concerns.
The human body’s metabolic needs decrease significantly
near death [1]. The digestive system weakens, making food absorption difficult
and potentially uncomfortable. Studies have shown that artificial hydration and
nutrition don’t improve lifespan or patient outcomes [2]. In fact, they can
increase the risk of aspiration pneumonia, a serious lung infection caused by
inhaling fluids [3].
Focus on Comfort, Not Calories:
When discussing food with families, emphasize that the
goal is comfort, not sustenance. Offer mouth swabs dipped in cool water or
flavored ice chips to alleviate dryness. Small, soft food pieces the patient
enjoys might be acceptable, but prioritize their wishes. Research by Kelley et
al. (2017) suggests focusing on the sensory experience of food, allowing
patients to savor familiar tastes without the burden of a full meal [4].
Addressing Emotional Concerns:
Families often equate food with love and nurturing.
Acknowledge these emotions and explain how forcing food can create a negative
association. Highlight the importance of spending quality time, holding hands,
and offering emotional support [5].
Clear Communication is Key:
Open communication is paramount. Use clear, concise
language, avoiding medical jargon, and answer questions honestly (Gabb et al.,
2019) [6]. Explain the physiological changes and potential complications of
forced feeding.
Empower families to participate in decision-making.
Present the evidence, but respect their cultural and religious beliefs. Guide
them towards prioritizing their loved one’s comfort while offering emotional
support throughout the process [7].
Collaboration with the Hospice Team:
Hospice nurses and social workers are experts in
navigating these discussions. The hospice team will work collaboratively to
develop a care plan that aligns with the patient’s needs and the family’s
wishes [8].
Conversations about food at the end-of-life can be
emotionally charged. Equipping medical professionals with clear communication
strategies can guide families toward prioritizing patient comfort while
respecting their wishes. By focusing on the body’s changing needs and
prioritizing comfort over forced feeding, healthcare teams can ensure a
peaceful transition for patients and their loved ones during this sensitive
time.
References:
- Wright,
B. M., & Sinclair, S. (2000). Palliative care for the dying patient.
The Lancet, 356(9242), 1658-1661.
- Sinuff,
T. M., & Schenker, Y. (2005). Palliative care: The evidence base for
opioid therapy, artificial nutrition and hydration, and other
interventions. The Journal of Pain, 6(2), 113-125.
- Marik,
P., & Rivera, D. (2013). Does artificial hydration prolong life in the
critically Ill? A systematic review of the literature. Chest Journal,
144(1), 336-345.
- Kelley,
L. M., Mitchell, G. D., & Carlson, L. E. (2017). Oral care and feeding
practices at the end of life in long-term care settings: A review of the
literature. Journal of Gerontological Nursing, 43(1), 32-40.
- Ferrell,
B. R., Coyle, N., & Paice, J. A. (2010). The Ferrell model of physical
symptoms management. Journal of Palliative Care, 26(2), 115-123.
- Gabb,
J. M., Morrison, R. S., & Clayton, J. M. (2019). Communication with
families about artificial nutrition and hydration at the end of life.
Current Opinion in Supportive and Palliative Care, 13(2), 118-123.
- Wright,
K. J., & Eluchard, J. M. (2015). Shared decision-making at the end of
life: A review of the role of communication. Nursing Ethics, 22(4),
444-459.
- Zimmermann,
C. K., Knauf, H., Greer, T. L., & LeClerc, C. M. (2007). The role of
hospice and palliative
- To view the original version of this article visit granehomehealthandhospice.com/food-at-end-of-life/
- Seniors Blue Book was not involved in the creation of this content.
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