Palliative care and stopping feeds

[EachandEveryone]

Is it normal to just stop feeding someone? Im not there so the information maybe confused. Mums sister had her second stroke two weeks ago. She is in her 80’s and its wiped her out. She seems better mentally and is talking and recognises and remembers the names of her six sisters. Her feeding tubes have been taken out and she is only on pain relief but doesnt seem to be in pain. My mum gave her drinks tonight and she asked if she was getting her ready for dying 😕 im a nurse but I cant get my head around what my mum is saying that they just arent feeding my aunt. Is she right?

Two things - if she’s having drinks, that tells me her swallow is OK, meaning she may be taking oral diet, hence the removal of the NG tube. Could this be the case?

Secondly, is she on TPN, perhaps?

She may have indicated that she does not want feeding tubes or she able to have food/supplements

No shes not able to do anything god love her. The second one has really wiped her out. My mum said theirs no drip and she was having the drinks on lollies. I know theyve stopped all her meds. Shes not got the capacity to make descisions for herself its just my poor mum seems to think shes improving everyday compared to last week when she just slept.

If she's had a stroke, her swallow will probably have been affected and she may be no longer able to chew and swallow foods. She would be at risk of aspiration if she eats and drinks. Thickened fluids can be given, but these are tiring to swallow.

As the body goes into decline it is normal not to want to eat and drink and it's a natural process. The body will produce endorphins in response to the lack of intake and this can increase feelings of comfort. The body also struggles to process foods and fluids and they can cause discomfort as digestive processes slow down and the heart weakens so will struggle to deal with increased fluids circulating.

The options for someone who is approaching end of life are to give mouth care with small amounts of fluid as and when the person is able to take them. Nutrition is generally not given as it can lead to choking, nausea, vomiting and abdominal discomfort.

The patient should always be given the option of taking fluids and nutrition if they feel up to it, but any food would need to be liquidised to prevent choking and fluids thickened to avoid aspiration.

Thank you so much for that. Its so sad she still has the same lovely smile.

My mum is not coping at all and shes worked in care homes all her life. She said shes never seen anyone to being fed anymore. My aunt is singing hymns and smiling and recognises everyone. My mum said she can face visiting anymore. 😔

Guidelines on withdrawal of feeding in palliative care have been updated quite recently, Each, and will be quite different in hospitals than in care homes. Is it worth having a chat to the treating team to discuss their rationale so it’s less distressing for you and your poor mum?

She will be moving to a care home shortly. Its my mum and her sisters they keep seeing improvements.

for you all. Hope is the cruellest thing at this stage.