Is it standard practice for a hospice to withhold nutrition and hydration from a patient. If you are knowledgeable about the subject, please answer quickly. This concerns a close relative.
No. When my dad went into hospice, it was explained very clearly that such a thing was not an option.
The hospice workers are about as close to angles on earth as is possible.
Tell them to not do it. Whomever is the patients advocate should have been talked to about this. Is the family not together on this?
I hate auto fill.
It depends on what the end-of-life (advance) directives say.
Some people specifically state that if they can’t eat on their own, no supplemental nutrition is to be supplied.
But, for most people, the hospice tries to keep them as comfortable as possible, meaning giving them food and water.
I know - it can be so obtuse.
It depends a lot on what you mean by withholding nutrition and hydration. It also depends on the specifics of the patient’s condition. Hospice doesn’t typically provide IV fluids for hydration. They also don’t typically place feeding tubes for people who are unwilling or unable to eat on their own. They don’t provide those interventions because they typically don’t contribute to patient comfort. But I’ve met plenty of families who would call that withholding nutrition/hydration. As far as oral intake of food and fluids that will depend on whether the patient can eat and drink without aspirating/choking, and whether the patient is still hungry or thirsty (often not the case at the end of life). Even in the case of patients who repeatedly aspirate the patient and family may decide in conjunction with the rest of the care team to continue feeding for emotional comfort. But in general if the patient wants to eat or drink and is physically able to do so, hospice would not prevent it.
No, it is not “standard practice”.
ETA When you have time, please elaborate.
Since this involves a medical issue, let’s move it to IMHO.
General Questions Moderator
It depends, I would assume, on how near gone that they are. When my grandmother (90) was moved from intensive care to a hospice, the policy was that they were not authorized to do anything with needles, so no option of IV nutrition or hydration. The only option for forced nutrition was through a tube. I elected not to do that. Since she was in a coma most of the time and had no remaning swollowing reflex even when somewhat concious, yes, that meant no food or water for the remainder of her life. Allowing her to quietly die from dehydration was (IMHO then and now) the lesser evil than shoving a tube down her throat to extend her dying by a few more days. This in no way seemed to be an unexpected or unusual situation from the POV of the (explicitly Catholic) hospice staff. If the patient is still willing and able to eat and drink somewhat normally (even if someone has to feed them) I can’t imagine that some place wouldn’t allow that, but if the patient is in a situation similar to my grandmother’s, hospices are there to help ease deaths, not extend lives.
As my MIL got into her final days we actually had to go through a rather detailed list of what we/she considered acceptable or not. Hydration yes; tube feeding not. They were kind, considerate and professional but it was still one of the longest and hardest tasks of my life for the maybe 15 minutes it took. Any hospice service that tries to force a decision/course of action on you and I would look up a lawyer ASAP.
Nitpick: hospices are never there to ease death; that’s completely antithetical to their philosophy. They are their to enhance your life. They just don’t equate that with prolonging your life.
From the “about us” link in my earlier post:
Do they withhold it? No. Can a patient refuse it? Certainly.
If a patient is too disabled to make their own decisions, that’s when things get really messy. That’s why it’s so important to have an advance directive, and let your friends and relatives know what you want.
All of you, thank you so much for your kind replies. I feel I have a better grasp of my relative’s situation now. I thought the hospice staff was merely enforcing a brutal arbitrary rule and was about to go off full blast on them. My younger brother stood in the room’s doorway and told me sternly I’d better know what the hell I was talking about before I did anything. I’m glad he did.
Which is what I said, surely? They don’t “ease death”; they “ease suffering” and provide care “to ensure that life is full and worthwhile until the end”.
I don’t want to split hairs, but this distinction is important to those who work in the hospice movement.
Its always tough when a loved one is maybe suffering and you know time may be short. Best to take a deep breath and count to ten.
I’m trying to wrap my head around this abstraction, and frankly I find it aggravating… It seens somewhat akin to corporate versions of “missions, visions, and values” proclamations.
My Brother-in-law died this past week under hospice’s care. My Mother and Father died in recent years under the same. One of my dearest friends died recently while in hospice. My sister is a hospice worker.
Never have I heard anyone intimately involved with any hospice patient claim that they were not invested in easing the patients transition to death… knowing full well that the patient’s remaining time (and death) is part of their life is sufficient cause to ease the transition by whatever means necessary as far as hospice is concerned.
Hospice is intended to allow terminally ill patients to die in a dignified, respectful, and in as pain free manner as possible…** not to “enhance” their lives.** That time has come and gone for them and everyone knows it.
People qualify for hospice as long as their life expectancy is deemed to be less than 6 months. Most of them don’t go to a free-standing hospice facility, either; only the bigger cities have them, and they’re more of a concept than a place anyway. And the staff will literally go anywhere, and “anywhere” can include jail, homeless shelters, any hospital ward, nursing homes, etc. but they do like to keep patients at home if it’s feasible and they want it.
I’ve seen people in hospice for as long as 2 years, and one who was enrolled and then died before they could fax us the paperwork. VERY rarely, a patient may leave hospice because their condition improves (this happened to Art Buchwald) but that is extremely rare.
I don’t understand what your point is.