01 09 10 Tweet Dietitians Eat Chocolate Too: Nutrition at the end of life. Weighing the options.

Saturday, November 15, 2008

Nutrition at the end of life. Weighing the options.

1 in 5 Baby Boomers are currently taking care of their parents or an elder relative, this group now nicknamed the "sandwich generation" for their dual care-giving roles as parents to teens and college age young adults and providing care for aging parents has applied a level of strain never before seen. You would think that with this many middle age Americans playing dual caretakers, there would be more support, but that isn't quite the case.

Now that I am working as a clinical RD, I've come across the problem frequently, I check a patient's chart, they might have just come from a nursing home, care-giver's home, or independent living, and there's a change in mental status, swallowing difficulty, and poor appetite/nutrition prior to their admission.
In more advanced cases of terminal illness, family has not made a decision on whether to provide nutrition support as in a tube feed or through the vein (in occasions if the stomach does not work--total parenteral nutrition--TPN). But what do we really know about nutrition in terminal/end of life situations? What scientific proof do we have that will enable us to make the best decisions we can live with? What kind of comfort care can be given to our loved ones that will make them pain free, without prolonging their illness?

"The patient and his or her family should talk with the doctor about the patient's medical condition and risks and benefits of giving artificial hydration and nutrition. Each situation is different. Your doctor can help you make the decision that is right for the patient and family (Artificial Hydration and Nutrition)."

I highly recommend reading the full article of "Nutrition Support at the End of Life: A Critical Decision" By M. Patricia Fuhrman, MS, RD, LD, FADA, CNSD, the link is posted at the end of the blog, the article provides a well rounded insight of the role of nutrition in end of life decisions, some of the things to expect with a loved one, and how to help yourself make the best decision.

  • "Artificial Hydration and Nutrition" http://familydoctor.org/online/famdocen/home/pat-advocacy/endoflife/629.html
  • "Nutrition Support at the End of Life: A Critical Decision" http://www.todaysdietitian.com/newarchives/082508p68.shtml