Artificial nutrition and hydration for the terminally ill: a reasoned approach

Knowledge about evidence-based research findings on the physiologic effects of artificial nutrition and hydration (ANH) can be used as a framework for assisting patients and families with decision making at the end of life. This article provides a review of the credible evidence related to ANH obtained through scientifically sound research, supplies a framework for discussion about ANH with patients and families, and lists basic educational recommendations and resources that both home health and hospice nurses can use to assist with patient and family supportive efforts. The charge to nurses caring for dying patients and their families is consistently to honor patient beliefs about life--their goals and values--in a supportive, unbiased, and informational manner, which will improve the quality of life--at the end of life.