The family's perspective on issues of hydration in terminal care

We identified issues that are important to family caregivers when deciding whether or not artificial hydration should be provided to patients with advanced cancer. A qualitative study using semi-structured interviews was carried out in the home support and inpatient divisions of a palliative care program in Halifax, Nova Scotia. Participants included children and spouses of terminally ill patients who had dealt with or would soon deal with issues of hydration. Factors influencing caregivers included issues of symptom distress, ethical and emotional considerations, information exchange between health professionals and family, and culture. The perceived benefits of artificial hydration by the caregivers were central to the ethical, emotional, and cultural considerations involved in their decision making. Discussions with caregivers should attempt to (a) discover the patient's wishes and attitudes concerning the procedure; (b) provide as accurate information as is available about advantages and disadvantages; and (c) recognize and explore caregivers' concerns that may or may not have been expressed.