Witnessing a loved one’s decline due to a terminal illness is undeniably difficult. This becomes even more poignant when hospice patients stop eating and drinking as their life nears its end. Understanding the complexities surrounding nutrition and hydration during hospice care is crucial for families and caregivers.
It’s natural to have concerns and questions, such as:
- Are we abandoning our loved one if we don’t encourage them to eat or drink?
- What are their chances of survival without food and water in hospice? How Long Does A Person Live Without Food and water in hospice care?
- Since food and drink are symbols of care in our family, are we withholding love by stopping nutrition and hydration?
- Will withholding food and water cause pain?
- How can we ensure our loved one remains comfortable?
Why Hospice Might Discourage Food and Water at the End of Life
Offering food and water, or resorting to artificial nutrition and hydration (ANH) like nasal (NG) or stomach (PEG) feeding tubes or IV fluids, can complicate the dying process and lead to further health issues.
Artificial nutrition in end-of-life patients can result in gagging, tube complications (blockages or infections), discomfort, aspiration pneumonia, pressure sores, bloating, and feelings of drowning or being trapped.
Studies also show that artificial nutrition offers minimal survival benefits for hospice patients. For instance, studies indicate that dementia patients who are tube-fed have similar life expectancies to those who are hand-fed.
The Complexities of Feeding Tubes
Hospice care will not be denied if a patient already has a feeding tube. The hospice team will collaborate with the patient, family, and caregiver to decide whether continued use is appropriate. While removal is technically possible, the common decision is to discontinue use.
Typically, feeding tubes are not placed in terminally ill patients. Instead, all measures are taken to ensure comfort and pain relief as the end of life approaches. In certain situations, the VITAS team might temporarily administer IV fluids to prevent dehydration or increase comfort, but oral feeding and drinking will be prioritized.
Determining When to Stop Feeding a Hospice Patient
A dying patient’s nutritional needs are very different from those of a healthy person. As death nears, the body’s ability to digest and process food and liquids diminishes. As organs and bodily functions cease, the need for nutrition and hydration might be minimal, if at all. Monitoring the body’s gradual decline can help determine when to stop feeding hospice patients.
VITAS Healthcare collaborates with patients and families to create personalized care plans that align with the patient’s wishes and values, including discussions about artificial nutrition and hydration.
How Long Can Someone Live Without Food in Hospice?
Given the many influencing factors, it’s understandable to wonder, “how long does a person live without food in hospice?” Following the cessation of eating, death can occur within a few days. However, for most individuals, this period typically lasts around 10 days, though in rare cases, it can extend to several weeks. The exact timeline varies significantly based on the individual’s overall health, disease progression, and other factors.
Supporting Your Loved One: The Role of Family and Caregivers
Patient choice should guide decisions about nutrition and hydration at the end of life. Patients who prioritize quality of life often prefer to avoid tubes and equipment, allowing them to be close to family and receive comfort care.
Family members and caregivers play a vital role by supporting their loved one during the dying process:
- If the patient can still eat or drink, offer small sips of water, ice chips, hard candy, or tiny amounts of food via spoon. Stop when the patient indicates.
- If the patient can no longer drink, keep the lips and mouth moist with swabs, a wet washcloth, lip balm, or moisturizers.
- If the patient can no longer eat or refuses to eat, offer alternative forms of nourishment like conversation, loving touch, music, singing, poetry, humor, pet visits, gentle massage, reading, or prayers.
Creating a Compassionate End-of-Life Care Plan
Ideally, end-of-life care decisions are made when everyone is healthy and able to communicate their wishes. This is the ideal time to create and share an advance directive with family and healthcare professionals.
However, decisions are often delayed until the patient can no longer communicate, leaving family and a knowledgeable healthcare team to make them. Hospice professionals can provide specific care and support regarding nutrition and hydration as death nears:
- The hospice team will continue to manage symptoms and relieve pain.
- The family’s personal, cultural, and religious beliefs about nutrition and hydration will be respected.
- Family members and caregivers will be educated on how to compassionately manage thirst and hunger without artificial means in the patient’s final days.
- Families will be reassured that the patient’s decline and eventual death are due to the underlying disease progression, not the natural decrease and cessation of eating and drinking. Understanding how long does a person live without food in hospice is just one aspect of providing comprehensive and compassionate end-of-life care.
