Witnessing a loved one’s decline due to a terminal illness is undoubtedly a difficult experience. This becomes even more challenging when family members and caregivers observe that the individual in hospice care stops eating and drinking. Understanding the complexities of this situation is crucial for providing compassionate and informed care.
Families often grapple with questions such as: Are we abandoning our loved one if we don’t force feeding or offer fluids? What are the chances of survival without food or water in hospice care? How long can a person in hospice live without food and water? Are we depriving them of love and causing unnecessary pain by withholding food and water? This article aims to address these concerns and provide a comprehensive understanding of nutrition and hydration in end-of-life care, focusing on the question of “How Long Can Elderly Live Without Food And Water.”
Why the Approach to Food and Water Changes in Hospice Care
The nutritional needs of a person nearing the end of life differ significantly from those of a healthy individual. Continuing to offer food and water, or opting for artificial nutrition and hydration (ANH) methods like nasal (NG) or stomach (PEG) feeding tubes or IV fluids, can sometimes complicate the dying process and lead to further health issues.
Patients receiving artificial nutrition at the end of life may experience gagging, tube complications (blockages, infections), discomfort, aspiration pneumonia, pressure sores, bloating, and feelings of drowning or being trapped. Research indicates that artificial nutrition has minimal impact on survival for hospice patients. For instance, studies reveal that dementia patients fed through tubes have a similar life expectancy to those who are carefully hand-fed.
The Complexities of Feeding Tubes in End-of-Life Care
Hospice care will not be denied to patients who already have feeding tubes in place. The hospice team collaborates with the patient, family, and caregiver to determine whether to continue using the tube. While removal is technically possible, the decision often involves simply ceasing its use.
Typically, feeding tubes are not inserted in patients nearing the end of life. However, all necessary measures are taken to ensure comfort and pain relief. In specific cases, the VITAS team might administer IV fluids temporarily to prevent dehydration or enhance comfort, but oral feeding and drinking remain the primary methods.
Determining When to Discontinue Feeding in Hospice
A dying patient’s needs for food and water are vastly different from those of a healthy, active person. As the end of life approaches, the body’s ability to digest and process food and liquids diminishes. As organs and bodily functions gradually shut down, the need for nutrition or hydration/liquids might be minimal, if present at all. The body’s natural decline serves as a crucial indicator for determining when to stop providing food and water to hospice patients.
VITAS Healthcare collaborates with patients and families to create customized care plans that align with the patient’s wishes and values, including discussions regarding artificial nutrition and hydration. This individualized approach ensures compassionate and patient-centered care.
Understanding the Timeline: How Long Can Elderly Live Without Food and Water?
Considering the numerous variables involved, it’s natural to wonder how long someone can live without food in hospice. The duration a person can live without food and water varies significantly. Following the cessation of eating and drinking, some patients may pass away within a few days. For the majority, this period typically lasts around 10 days, but in rare cases, it can extend for several weeks. Factors such as the patient’s overall health, the underlying disease, and the level of hydration before stopping eating and drinking all influence the timeline. Therefore, there is no single answer to the question of “how long can elderly live without food and water.”
The Role of Family and Caregivers in Providing Comfort
Patient choice is paramount when making decisions regarding nutrition and hydration at the end of life. Patients prioritizing quality of life often prefer to avoid tubes and equipment, allowing them to be physically closer to family members and receive desired comfort care.
Family members and caregivers play a vital role in supporting their loved one through the dying process:
- If the patient can still eat or drink, offer small sips of water/liquids, ice chips, hard candy, or tiny amounts of food via spoon. Pay close attention to the patient’s cues to know when to stop.
- If the patient can no longer drink, maintain moisture in the lips and mouth using swabs, a wet washcloth, lip balm, or moisturizers.
- If the patient can no longer eat or refuses to eat, offer alternative forms of nourishment, such as conversation, loving touch, music, singing, poetry, humor, pet visits, gentle massage, reading, prayers, or other acts of caring and love. These actions focus on providing comfort and emotional support, recognizing that nourishment extends beyond just food and water.
Creating and Honoring a Compassionate End-of-Life Care Plan
Ideally, end-of-life care decisions should be made when everyone is healthy and able to express their preferences. This is the optimal time to create an advance directive and share it with family and healthcare professionals.
In reality, these decisions are often delayed until the patient can no longer communicate their wishes, leaving family members and the healthcare team to make informed choices. Hospice professionals offer specialized care and support related to nutrition and hydration as death approaches:
- The hospice team will continue to alleviate pain and manage symptoms.
- The family’s personal, cultural, and religious beliefs and values regarding nutrition and hydration will be respected.
- Family members and caregivers will learn how to compassionately manage thirst and hunger without artificial means during the patient’s final days.
- In the final weeks, days, and hours of life, families will receive reassurance that the patient’s decline and eventual death result from the progression of the underlying disease, not from the natural decrease and eventual cessation of eating and drinking. Understanding this distinction is crucial for alleviating guilt and providing peace of mind.
