# QUICK ANSWER PLEASE: Do hospices routinely withhold nutrition and hydration from a patient?

**URL:** https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650
**Category:** In My Humble Opinion
**Created:** [October 28, 2018, 11:14pm UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650 "2018-10-28T23:14:32Z")
**Posts on this page:** 20
**Page:** 1

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### Author: ![The\_Plutonium\_Kid](https://avatars.discourse-cdn.com/v4/letter/t/8baadc/32.png) [@The\_Plutonium\_Kid](https://boards.straightdope.com/u/The_Plutonium_Kid)
#### Post date: [October 28, 2018, 11:14pm UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/1 "2018-10-28T23:14:32Z")

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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.

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### Author: ![Dobbs](https://avatars.discourse-cdn.com/v4/letter/d/5f9b8f/32.png) [@Dobbs](https://boards.straightdope.com/u/Dobbs)
#### Post date: [October 28, 2018, 11:40pm UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/2 "2018-10-28T23:40:25Z")

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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.

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### Author: ![Beckdawrek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beckdawrek/32/3647_2.png) [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)
#### Post date: [October 28, 2018, 11:42pm UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/3 "2018-10-28T23:42:39Z")

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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?

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### Author: ![Dobbs](https://avatars.discourse-cdn.com/v4/letter/d/5f9b8f/32.png) [@Dobbs](https://boards.straightdope.com/u/Dobbs)
#### Post date: [October 28, 2018, 11:44pm UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/4 "2018-10-28T23:44:16Z")

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Angels.

I hate auto fill.

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### Author: ![beowulff](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beowulff/32/542_2.png) [@beowulff](https://boards.straightdope.com/u/beowulff)
#### Post date: [October 28, 2018, 11:45pm UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/5 "2018-10-28T23:45:30Z")

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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.

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### Author: ![Mangetout](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mangetout/32/19_2.png) [@Mangetout](https://boards.straightdope.com/u/Mangetout)
#### Post date: [October 28, 2018, 11:59pm UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/6 "2018-10-28T23:59:38Z")

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> [@Dobbs](#):
>
> Angels.
> 
> I hate auto fill.

I know - it can be so obtuse.

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### Author: ![pendgwen](https://avatars.discourse-cdn.com/v4/letter/p/3da27b/32.png) [@pendgwen](https://boards.straightdope.com/u/pendgwen)
#### Post date: [October 29, 2018, 12:31am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/7 "2018-10-29T00:31:03Z")

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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.

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### Author: ![steatopygia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/steatopygia/32/3132_2.png) [@steatopygia](https://boards.straightdope.com/u/steatopygia)
#### Post date: [October 29, 2018, 12:42am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/8 "2018-10-29T00:42:19Z")

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> [@The\_Plutonium\_Kid](#):
>
> 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, it is not “standard practice”.

ETA When you have time, please elaborate.

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### Author: ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)
#### Post date: [October 29, 2018, 12:56am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/9 "2018-10-29T00:56:54Z")

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Since this involves a medical issue, let’s move it to IMHO.

Colibri  
General Questions Moderator

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### Author: ![Darren\_Garrison](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/darren_garrison/32/92_2.png) [@Darren\_Garrison](https://boards.straightdope.com/u/Darren_Garrison)
#### Post date: [October 29, 2018, 1:10am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/10 "2018-10-29T01:10:00Z")

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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](http://www.openarmshospice.org/open_arms.php)) 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.

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### Author: ![kopek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kopek/32/337_2.png) [@kopek](https://boards.straightdope.com/u/kopek)
#### Post date: [October 29, 2018, 1:31am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/11 "2018-10-29T01:31:29Z")

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> [@beowulff](#):
>
> 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.

This.

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.

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### Author: ![UDS](https://avatars.discourse-cdn.com/v4/letter/u/ecae2f/32.png) [@UDS](https://boards.straightdope.com/u/UDS)
#### Post date: [October 29, 2018, 1:32am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/12 "2018-10-29T01:32:12Z")

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> [@Darren\_Garrison](#):
>
> . . . . but if the patient is in a situation similar to my grandmother’s, hospices are there to help ease deaths, not extend lives.

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.

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### Author: ![Darren\_Garrison](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/darren_garrison/32/92_2.png) [@Darren\_Garrison](https://boards.straightdope.com/u/Darren_Garrison)
#### Post date: [October 29, 2018, 1:37am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/13 "2018-10-29T01:37:01Z")

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> [@UDS](#):
>
> Nitpick: hospices are never there to ease death; that’s completely antithetical to their philosophy.

From the “about us” link in my earlier post:

> [@](#):
>
> …provides the kind of care, support, and nurturing for patients and their families that helps ease the suffering of a life-limiting disease. We never attempt to cure the terminal patient, nor do we ever provide false hope. Rather, we provide care beyond the cure to ensure that life is full and worthwhile until the end…

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### Author: ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)
#### Post date: [October 29, 2018, 2:05am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/14 "2018-10-29T02:05:36Z")

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> [@The\_Plutonium\_Kid](#):
>
> 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.

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.

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### Author: ![The\_Plutonium\_Kid](https://avatars.discourse-cdn.com/v4/letter/t/8baadc/32.png) [@The\_Plutonium\_Kid](https://boards.straightdope.com/u/The_Plutonium_Kid)
#### Post date: [October 29, 2018, 3:05am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/15 "2018-10-29T03:05:27Z")

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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.

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### Author: ![UDS](https://avatars.discourse-cdn.com/v4/letter/u/ecae2f/32.png) [@UDS](https://boards.straightdope.com/u/UDS)
#### Post date: [October 29, 2018, 3:45am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/16 "2018-10-29T03:45:48Z")

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> [@Darren\_Garrison](#):
>
> From the “about us” link in my earlier post:

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.

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### Author: ![kopek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kopek/32/337_2.png) [@kopek](https://boards.straightdope.com/u/kopek)
#### Post date: [October 29, 2018, 3:47am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/17 "2018-10-29T03:47:35Z")

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> [@The\_Plutonium\_Kid](#):
>
> 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.

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.

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### Author: ![ZurBob](https://avatars.discourse-cdn.com/v4/letter/z/71e660/32.png) [@ZurBob](https://boards.straightdope.com/u/ZurBob)
#### Post date: [October 29, 2018, 4:26am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/18 "2018-10-29T04:26:51Z")

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> [@UDS](#):
>
> 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.

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.

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### Author: ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)
#### Post date: [October 29, 2018, 4:46am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/19 "2018-10-29T04:46:36Z")

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> [@ZurBob](#):
>
> 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.

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### Author: ![ZurBob](https://avatars.discourse-cdn.com/v4/letter/z/71e660/32.png) [@ZurBob](https://boards.straightdope.com/u/ZurBob)
#### Post date: [October 29, 2018, 4:49am UTC](https://boards.straightdope.com/t/quick-answer-please-do-hospices-routinely-withhold-nutrition-and-hydration-from-a-patient/823650/20 "2018-10-29T04:49:40Z")

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I don’t understand what your point is.

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