What is artificial nutrition?
Artificial nutrition and/or hydration is a treatment that delivers fluids and/or nutrition by means other than a person taking something in his/her mouth and swallowing it. There are several types of artificial nutrition and hydration, including a tube placed in the gastrointestinal tract that is passed through the nose and throat, or delivered via a catheter placed in a vein of the body.
When are artificial food and fluids considered?
- When a person is nearing the end of life, adding artificial food and fluids is not likely to make the person stronger or prolong their life and may cause uncomfortable symptoms.
- When a person with a temporary or chronic illness is expected to recover and cannot swallow or properly digest food or fluids, a feeding tube or intravenous fluids may help.
- Artificial nutrition may be recommended for people with head and neck cancer, partially reversible neurological conditions, multiple sclerosis, amyotrophic lateral sclerosis or those who suffered a stroke.
- Artificial nutrition may not be recommended if it may prolong death for terminally ill patients, increase discomfort, be unhelpful or cause bowel obstructions.
What may happen if artificial fluids and nutrition are given near the end of life?
- Artificial food and fluids may make some symptoms worse because the body systems are slowing and cannot process the food and fluids it does not need.
- Feeding tubes may put a person at increased risk for pneumonia, and may also cause pain, nausea and vomiting.
- Tubes for food and fluids are potential sites for infection.
- In a person who is dying, artificial food and fluids may increase in the lungs, create difficulty breathing, cause nausea, vomiting and urinary incontinence.
What happens if artificial food and fluids are not given near the end of life?
- Dehydration from being unable to take in food or fluids does not affect the dying patient in the same way as a healthy person who feels thirsty on a hot day.
- The lack of fluids seems to produce a natural anesthetic effect often allowing for a reduction of pain medication.
- Dehydration will reduce urine output and often provides a decrease in awareness of pain or other uncomfortable symptoms. It may help contribute to a peaceful, comfortable death.
- Near the end of life, if the person is unable to take any food or fluids, they will gradually become weaker and sleep more.
Will the person nearing death who does not receive artificial food and fluids be thirsty?
- Usually, the person does not experience thirst or hunger.
- If a person has thirst, it will only last a day or so and ice chips or small chips of fluid with good oral care should relive the symptom.
Should I consider artificial nutrition for my loved one?
This is an individual decision that must be decided on a case-by-case basis. The Arbor Hospice care team are willing to discuss the benefits of artificial nutrition and the burdens it may cause.
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