Dehydration and hydration in the terminally ill: care considerations

Area of Science:

• Palliative Care
• Clinical Nursing
• End-of-Life Care

Background:

• Ongoing debate exists regarding the withholding or withdrawal of artificial hydration (intravenous, subcutaneous, nasogastric) in terminally ill patients.
• Nurses frequently encounter situations requiring patient or family decisions about hydration.
• A knowledge base regarding terminal dehydration is essential for healthcare providers.

Purpose of the Study:

• To review the existing literature on terminal dehydration.
• To explore the definition, physiological benefits, and disadvantages of terminal dehydration.
• To examine the rationale for hydration, relevant research, and the physiological basis for comfort in terminally dehydrated individuals.

Main Methods:

• Literature review of terminal dehydration.
• Analysis of physiological effects of hydration and dehydration.
• Synthesis of research findings on comfort in terminally ill patients.

Main Results:

• Terminal dehydration has defined physiological characteristics.
• Potential benefits and disadvantages of artificial hydration in the terminally ill are discussed.
• Research indicates a physiological basis for comfort in terminally dehydrated patients, challenging the routine need for hydration.

Conclusions:

• Nurses require comprehensive knowledge of terminal dehydration to support patients and families in end-of-life care decisions.
• Evidence suggests that withholding or withdrawing hydration may not cause discomfort and can be a natural dying process.
• Further research and clear practice guidelines are needed to address hydration management in terminally ill patients.