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Hydration in the terminally ill patient

N Malone

    Nursing Standard (Royal College of Nursing (Great Britain) : 1987)
    |July 20, 1994
    PubMed
    Summary

    Dehydration in terminally ill patients may improve comfort, contrary to common medical belief. This article explores the benefits of dehydration in end-of-life care, challenging the routine use of intravenous fluids.

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    Area of Science:

    • Palliative Care
    • End-of-Life Symptom Management
    • Clinical Hydration

    Background:

    • Conventional medical practice often views dehydration in terminally ill patients as uncomfortable and painful.
    • Intravenous fluid administration is frequently recommended to maintain hydration in patients nearing the end of life.
    • This approach is based on the assumption that hydration is essential for patient comfort.

    Purpose of the Study:

    • To critically examine the practice of hydration in terminally ill patients.
    • To analyze the theoretical, practical, ethical, and legal aspects of hydration and dehydration at the end of life.
    • To challenge the prevailing view and explore potential benefits of dehydration for patient comfort.

    Main Methods:

    • Review of existing literature and medical guidelines on hydration in palliative care.
    • Theoretical analysis of the physiological and psychological effects of dehydration in the context of terminal illness.
    • Ethical and legal considerations regarding patient autonomy and medical interventions.

    Main Results:

    • Evidence suggests that dehydration, rather than causing distress, may lead to a more peaceful dying process.
    • Reduced fluid intake can decrease respiratory secretions, edema, and the need for frequent repositioning.
    • The sensation of thirst may be less pronounced than commonly assumed in the final stages of life.

    Conclusions:

    • The routine administration of intravenous fluids to dying patients may not always be beneficial and could potentially cause discomfort.
    • Dehydration might offer significant benefits for the comfort and symptom management of terminally ill patients.
    • Healthcare professionals should reconsider the standard approach to hydration in end-of-life care, prioritizing patient comfort and exploring the advantages of natural dehydration.
    Keywords:
    Death and Euthanasia

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