Social work and end-of-life care

Social work is important in end-of-life care

Medically-assisted hydration and nutrition: authoritative research reviews

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Lots of people in palliative care face questions from patients and relatives about whether the common practice in palliative care to withdraw artificial (tube) feeding and hydration is right. Common sense tells many people that this removes the opportunity for patients to improve or recover and in effect starves them or leaves them thirsty. There are authoritative ‘Cochrane’ reviews of research in this area, which it may be useful to refer to.

Broadly they show that there is no good evidence that artificial feeding and hydration provides benefits or withdrawal of it reduces survival and there are some problems if people are artificially hydrated because they may retain too much water in their bodies. The reason is that not enough studies have been done to make a clear recommendation.

The sensible course is probably not to make too much of research either way, and to encourage people to have open discussions with patients and families in which they can express their concerns fully. It’s one of those examples where research has not been done on something that really concerns people. But at least there’s no evidence that withdrawing artificial nutrition and hydration actually does leave them without sustenance.

Link to Cochrane study on artificial nutrition.

Link to Cochrane study on artificial hydration.

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Written by Malcolm Payne

3 September 2014 at 1:22 pm

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