Dehydration & Starvation – Myths & Realities PDF Print E-mail
Saturday, 17 May 2014 00:00

There are many misunderstandings regarding the need for food and fluids at the end-of-life.  The following information will hopefully help seniors and their families make more informed choices regarding the type of care they desire.

 

 

Myths

Common beliefs regarding the need for food/fluids as we approach the end-of-life:

1.“Dehydration & starvation are painful.”

2.“Providing IV (intravenous) fluids will make a terminally ill person more comfortable.”

3.“We cannot allow someone to starve to death.”

 

Realities

Healthy people who don’t eat or drink become hungry, thirsty, and uncomfortable.

But, in studies with volunteers dying from diseases like cancer, Lou Gehrig’s Disease [ALS], dehydration & malnourishment were not shown to be painful.  A lack of food and water actually promoted comfort because of chemical changes that occurred in the body and in the brain.

For those actively dying (the last one to two weeks of life), artificial fluids (an IV) promotes discomfort:  lungs sound ‘wetter’, the bladder fills more, the brain is more aware of pain, and the sensation of hunger is enhanced.

By interfering in this final stage of life, by altering the normal chemical process, artificial hydration delays death and prolongs suffering.  If we allow “nature to take its course”, almost everyone who is terminally ill and is unable to swallow fluids will die within two to ten days (depending on diseases present, general health, etc.)—artificial fluids can prolong dying for weeks.

Families need to know that the disease causes a person to die, not starvation from the withholding of fluids or food.  The disease leads to dehydration and death, not starvation. Prior to our modern technology (such as IV’s and feeding tubes), people were described as dying of “natural causes” and not as “starving to death”.

 

Conclusions

At the very end of life:  (1) dehydration & starvation are not painful, (2) providing IV fluids does not keep a terminally ill person more comfortable, (3) IV fluid administration can prolong death, and (4) a dying person does not “starve” to death.

As a loved one declines, everyone—families, friends, seniors, doctors, and nurses—can be reassured that avoiding artificial interventions just allows “nature” to take its course and proceed as intended, peacefully.

 

 

References

1.Ng K. Symptoms and attitudes of 100 consecutive patients admitted to an acute hospice/palliative care unit. J Pain Symptom Manage. 1998.

2.McCann R, et al. Comfort care for terminally ill patients. JAMA. 1994.

3.McGeer A, et al. Parenteral nutrition in patients receiving cancer chemotherapy. Ann Intern Med. 1989.

4.Fainsinger R. The management of dehydration in terminally ill patients. J Palliat Care. 1994.

 

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Last Updated on Saturday, 17 May 2014 01:58