— Decreasing food and fluid intake is a common, natural part of the dying process. — Most dying people do not experience thirst or hunger as death approaches. — Giving food and fluids by artificial means (e.g., intravenously) does not usually prolong life or improve its quality.
For most people with only hours or days to live their body systems shuts down and thirst is not a problem. Strange as it may sound there are definite advantages to taking less food and drink at this time. The loss of appetite and thirst is nature's way of helping the body prepare for a peaceful death.
Our study suggests that a higher amount of fluid intake during 48–25 hours before death may be associated with the occurrence of terminal restlessness during the last 24 hours of life. These results suggest that actively providing dying patients with artificial fluid may not be beneficial.
End Of Life Parenteral Fluids
It is preferable to die dry than to die wet. This is at least the basic idea of traditional hospice and palliative thought, when parenteral fluids (intravenous or subcutaneous) are often avoided near the end of life to prevent fluid accumulation in the lung and other organs.
Hospice agencies do not stop their patients from eating or drinking during hospice care. Instead they are simply active in making sure the patients are not overeating or overdrinking, which can cause further suffering during the dying process.
When someone stops taking fluids and is bedridden (and thus requires little fluid), they may live for a few days or as long as a couple of weeks. People lose their sense of hunger and thirst during the normal dying process.
If you stop eating and drinking, death can occur as early as a few days, though for most people, approximately ten days is the average. In rare instances, the process can take as long as several weeks.
Family members and caregivers play an important role by supporting a loved one through the dying process: If the patient can still eat or drink, offer small sips of water/liquids, ice chips, hard candy or very small amounts of food via spoon. Take cues from the patient when to stop.
The active stage of dying generally only lasts for about 3 days. The active stage is preceded by an approximately 3-week period of the pre-active dying stage. Though the active stage can be different for everyone, common symptoms include unresponsiveness and a significant drop in blood pressure.
Hospice care emphasizes symptomatic and palliative medicine. The goal is to maximize the patient's quality of life. Hospice treatment involves IV hydration and nourishment. Nothing is removed in hospice.
Dehydration is a normal process during the last days of life that act as a natural anaesthetic at the end of life. This anaesthetic effect can be explained in the following different ways: Fewer bouts of vomiting due to reduced gastrointestinal fluid. Decreased oedema and swelling.
Oedema is the medical word for a build-up of fluid in the body, which causes swelling. The most common types of swelling for people living with a terminal illness are: peripheral oedema – swelling under the skin, often in the legs. lymphoedema – swelling under the skin caused by problems in the lymphatic system.
The first organ system to “close down” is the digestive system. Digestion is a lot of work! In the last few weeks, there is really no need to process food to build new cells. That energy needs to go elsewhere.
Decompensation progresses over a period of minutes even after the pulse is lost. Even when vascular collapse is the primary event, brain and lung functions stops next. The heart is the last organ to fail.
When someone is nearing the end of life, they experience a variety of symptoms. Pain, shortness of breath, anxiety, incontinence, constipation, delirium, and restlessness are just a few signs that a loved one is going through the dying process.
Irregular breathing, panting and periods of not breathing may occur. Changes in breathing are very common and indicate a decrease in circulation to the internal organs. While these changes are not usually bothersome to the patient, they can be distressing to family members. Elevating the head may provide relief.
The surge of energy before death lasts between a few minutes and several hours. This phenomenon typically occurs in the final days or hours of a person's life. A sudden increase in mental clarity, physical strength, or emotional expression marks it.
Seriously ill patients encountered by hospice and palliative care clinicians are at risk for thirst due to dehydration, electrolyte disturbances, hypotension, xerostomia, and immobility which can impede access to water.
Hospice experts advise families to avoid such a “food struggle” by allowing your loved one to eat what they want when they want. Withholding nutrition at the end of life and not eating can actually help reduce discomfort from a weakened digestive system.
Dry mouth at the end of life
If the patient is conscious, moisten their mouth every 30 minutes with water from a spray or dropper, or by placing ice chips in their mouth. If the patient is unconscious, use a spray, dropper or ice chips every hour.
During the dying process, body learns to reduce and eventually eliminate the need for liquids and food. The body has begun to shut down; preparations are over. Therefore, getting them to eat or drink will not comfort them even though we usually use food to comfort our family.
A reduction in appetite is one sign that someone may be in the last days of their life. They may no longer wish to eat or drink anything. This could be because they find the effort of eating or drinking to be too much. But it may also be because they have little or no need or desire for food or drink.
Avoid talking in an overly optimistic way, for example, “You'll be up in no time”. Such comments block the possibility of discussing how they're really feeling – their anger, fears, faith and so on. Apologise if you think you've said the wrong thing. Let them know if you feel uncomfortable.