Palliative care is an approach that improves the quality of life of individuals and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. (WHO definition of palliative care).
Nutrition and hydration are important throughout all of the above life stages, including end of life. It can be a confusing and a difficult time for all.
There is often conflict about nutrition in the palliative phase. On the one hand, the family, friends, carers focus on the provision of food and fluids as an act of love. Providing food is one thing that they can do when all other aspects of their loved one’s care is out of their control. At the same time, the individual feels tension because they are grateful for the food offered, but are unable to eat and drink as they have in the past, and this can result in guilt because they can feel how stressed their family and friends are about their poor intake.
At this time there are often a number of problems that may be contributing to poor oral intake, including:
It is important to reach a stage where both parties are aware of the issues involved, and can come to a compromise about how nutrition and hydration will be managed, so that everyone can enjoy quality time together. Importantly, nutrition and palliative care must be a team approach which includes the individual, family, friends, carers, nurses, GP’s, members of the allied health team, such as Dietitian’s, Speech Pathologists, and the food services team.
Where palliative and terminal care are concerned, nutrition and hydration is less about the 5 core food groups and nutritional balance and adequacy, and more about the provision of food and fluids that are in keeping with the individual and family/ carer preferences, to achieve comfort and the best quality of life that is possible.
It is important that the focus of food be upon offering foods that the individual enjoys, in quantities that they are able to manage. Some of the following tips may be helpful
Most of all, respect the individual’s right to choose how they will eat and drink.
While it is preferable to try food first, nutritional supplements can provide nutritional assistance where required.
It’s a privilege to share in someone’s final journey – embrace your part in it.