Summary
Freda’s son has arrived from America and is reassured that his mother is being kept comfortable and that he can be with the family at her bedside for her last few hours.
Key Messages
- Decisions about alternative methods of providing nutrition and hydration should be reached using a shared decision making approach
- Shared decision making allows for possible treatment options, risks, benefits and evidence to be discussed with the patient and their family. The patient’s individual preferences, goals, values and beliefs can also be taken into consideration
- Learning methods of oral nutrition support. e.g the use of modified diet and fluids within stroke care, the use of a ‘food first’ approach and oral nutritional supplements to support poor dietary intake post stroke.
- The risk of Refeeding syndrome is high in patients who have nutrition recommenced following a period of over 5 days of nil or minimal intake.
- Assessment of a patient’s capacity is essential to their care planning and appropriate communication support should be provided when required
- Capacity is task specific and can change over time, thus the capacity status should be reviewed regularly
- Nasal retention devices and restraints eg. posey mitts may be indicated in some cases when there is repeated attempts to remove/dislodge NG tubes. Use of these should be considered on an individual basis and according to local protocols
- Ethical decisions around the provision of food and fluids in end-of-life care can be complex and the team need to respond to these on an individual basis
Page last reviewed: 19 Nov 2021
