Hospice may become necessary for end-of-life care for the terminally ill and elderly. According to the Hospice Foundation of America, hospice is medical care that maintains or improves the quality of life for someone who is suffering from illness, disease or a condition that cannot be cured. Because each patient’s needs are different, a customized care plan is developed to address the various physical, emotional and spiritual challenges that come with terminal illness. A big part of hospice care is nutrition.
It also raises a lot of questions: should my spouse get a feeding tube if she can’t swallow? Should my dad get intravenous fluids if he stops drinking and gets dehydrated? These can be tough questions to ask and answer, especially when there is so much uncertainty regarding the effectiveness or lack thereof for supplemental nutrition at end of life. Also, it’s important to find out what burdens, side effects and complications each treatment can place on the patient and the caregivers, says the American Hospice Foundation.
That are many ways hospice care in San Francisco can help with end of life nutrition. Let’s explore five of them.
1. Education on religious, ethical and legal concerns
Nutritional support therapy is considered a type of medical therapy. Therefore, there are many emotions, legal concerns, and religious beliefs at play here. Providing nutritional sustenance often appeases patients and family members who may be unclear on understanding medical indications for nutrition support as well as the benefits of it. Many religions do not permit the withdrawal of nutritional efforts during end of life. For example, the Southern Baptist Convention, the nation’s largest Protestant denomination, opposes any action that may hasten death, including stopping regular medical treatment and the cessation of food and water, according to Pew Research Center.
In terms of legality, choosing to stop treatment that does not cure or control an illness, or deciding not to start a new treatment, is legal, whether that decision is made by the person who is dying or by the person making healthcare decisions, says the National Institute on Aging.
The hospice care team is in place to educate patients and their families as to the benefits and drawbacks of nutrition at end of life.
2. Reduce effects of dehydration.
Withholding hydration can lead to dry mouth, which can become quite uncomfortable for the patient. In addition to providing proper hydration, other oral hygiene measures can be taken, such as lip and mouth lubrication, ice chips and mouth swabs. Dehydration can also lead to confusion, lethargy and hypernatremia, which is a common electrolyte problem defined as a rise in serum sodium concentration caused by a decrease in total body water relative to electrolyte content, according to Medscape.
3. Ensure comfort as part of hospice care in San Francisco
Making a dying patient more comfortable is a big role in hospice care. Discomfort can stem from many issues, including digestive issues, fatigue and temperature sensitivity. The home hospice team can determine those pain points and make the necessary adjustments in nutritional support as well as ensure a comfortable surrounding.
4. Making critical decisions.
The loss of a loved one’s appetite can be difficult to accept in your dying loved one. Many people fear their loved one will literally starve to death or that they are feeling extreme hunger. However, it is very common for patients at the very end of life to not care about food and drink. They may not even feel hunger in terms that we can relate to. If they are forced to eat or drink when they do not want to, they can even experience discomfort or complications such as bloating, nausea and vomiting, diarrhea or constipation.
Hospice care professionals recognize those signs, adjust the treatment plan, and educate families on what’s really going on.
5. Working with families through all stages.
The above effects don’t typically happen until the last days of life. Since many people are in hospice for up to six months, they often enter with the ability to still eat, chew and swallow normal table foods. It’s at this time that a dietitian can work with the family to come up with a diet that meets their needs. Some tips they may provide include:
- To offer five or six small meals a day rather than three
- Choose foods that the patient wants to eat. Even a favorite food may not hold much appeal anymore.
- Serve room temperature foods or cold foods, as strong smells, especially during the cooking process, can induce nausea.
- Serve soft foods such as pudding, cottage cheese, yogurt, ice cream and beans. Patients often lose their ability to chew tough foods, which is why meat is usually one of the first things to go. The beans will replace the protein they are losing.
Contact Pathways Home, Health and Hospice
We can provide expert care in your time of need. Contact us at 888-755-7855 to learn more about our hospice care services, including nutrition at end of life.
