Abstract
Nutritional support during the last days of a dying patient is a critical issue that must be resolved by careful discussion between families, caregivers, and the health care team. Eating is such an integral part of life that when a loved one no longer wants to eat or cannot eat, some families and physicians feel they must do something to correct the situation. Food nourishes us, satisfies us when we are hungry, and comforts us in times of need. We celebrate everything with food and talk of food as “nourishing people back to health.” We prepare and share meals as a way of expressing love and concern. In many instances, however, there is a natural decline in the desire and ability to eat by a family member with a terminal illness, which may be hard for caregivers to understand or accept. Health care providers need to be well-versed in issues regarding artificial nutrition and hydration in terminal illness in order to assist patients and their families in treatment decisions.
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References
Bioethicists’ statement on the US Supreme Court’s Cruzan decision. NEJM 1990; 323: 686–687.
Burck R. Feeding, withdrawing, and withholding: ethical perspectives. Nutr Clin Prac 1996; 11: 243 253.
Bouvia v. Superior Court (Glenchur) 179 Cal. App. 3d 1127, 225 Cal. Rptr. 297 [Ct. App. 1986 ].
Bioethicists’ statement on the US Supreme Court’s Cruzan decision. NEJM 1990; 323: 686–687.
Dewys WD, Begg C, Lavin PT, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med 1980; 69: 491–497.
Nelson KA. The cancer anorexia-cachexia syndrome. Semin Oncol 2000; 27: 64–68.
Jaskowiak NT, Alexander HR. The pathophysiology of cancer cachexia. In: Oxford Textbook of Palliative Medicine, 2nd ed. Doyle D, Hanks GWC, MacDonald N (eds.), Oxford University Press, Oxford, 1998, pp. 534–547.
Tisdale MJ. Cancer cachexia: metabolic alterations and clinical manifestations. Nutrition 1997; 13: 1–7.
Maltoni M, Nanni O, Scarpi E, Rossi D, Serra P, Amadori D. High-dose progestins for the treatment of cancer anorexia-cachexia syndrome: a systematic review of randomized clinical trials. Ann Oncol 2001; 12: 289–300.
Bruera E, Fainsinger RL. Clinical management of cachexia and anorexia. In: Oxford Textbook of Palliative Medicine, 2nd ed. Doyle D, Hanks GWC, MacDonald N (eds.), Oxford University Press, Oxford, 1998, pp. 550–555.
McCann RM, Hall WJ, Groth-Juncker A. Comfort care for terminally ill patients: the appropriate use of nutrition and hydration. JAMA 1994; 272: 1263–1266.
Evans DA, et al. Prevalence of Alzheimer’s Disease in a community population of older patients. JAMA 1989; 262: 2551–2556.
Gillick MR. Rethinking the value of tube feeding in patients with advanced dementia. NEJM 2000; 342: 206–210.
Primary Care Internal Medicine. In: Medical Knowledge Self-Assessment Program. American College of Physicians, Philadelphia, PA, 1998, p. 71.
Finucane TE, Christmas C, Travis K. Tube feeding in patients with advanced dementia: a review of the evidence. JAMA 1999; 282: 1365–1370.
Berlowitz DR, Brandeis GH, Anderson J, Brand HK. Predictors of pressure ulcer healing among longterm care residents. JAGS 1997; 45: 30–34.
Berlowitz DR, Ash AS, Brandeis GH, Brand HK, Halpern IL, Moskowitz MA. Rating long-term care facilities on pressure ulcer development: importance of case-mix adjustment. Ann Int Med 1996; 124: 557–563.
Gillick MR. Rethinking the value of tube feeding in patients with advanced dementia. NEJM 2000; 342: 206–210.
Sanders DS, Carter MJ, D’ SilvaJ, James G, Bolton RP, Bardham KD. Survival analysis in percutaneous endoscopic gastrostomy feeding: a worse outcome in patients with dementia. Am J Gastroenterol 2000; 95: 1472–1475.
Suski NS, Nielsen CC. Factors affecting food intake of women with Alzheimer’ s type dementia in longterm care. JADA 1989; 89: 1770–1773.
Friedel DM, Ozick LA. Rethinking the role of tube feeding in patients with advanced dementia (letter; comment). NEJM 2000; 342: 1756.
Weissman DE. Establishing treatment goals, withdrawing treatments, DNR orders. In: Improving Endof-Life Care: A Resource Guide for Physician Education. Weissman DE (ed.), The Medical College of Wisconsin, Inc., Milwaukee, WI 1998, pp. 94–100.
McCann RM, Hall WJ, Groth-Juncker A. Comfort care for terminally ill patients: the appropriate use of nutrition and hydration. JAMA 1994; 272: 1263–1266.
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Furman, C.D., Ritchie, C.S. (2004). Nutrition and End-of-Life Care. In: Bales, C.W., Ritchie, C.S. (eds) Handbook of Clinical Nutrition and Aging. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-391-0_14
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DOI: https://doi.org/10.1007/978-1-59259-391-0_14
Publisher Name: Humana Press, Totowa, NJ
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