Eating, Drinking, and Comfort at End-of-Life: Promoting a Quality of Death

Author:

Askren Annette N.1ORCID,Kershner Marnie2

Affiliation:

1. VA Puget Sound Health Care System, Seattle, WA

2. MedStar National Rehabilitation Hospital, Washington, DC

Abstract

Purpose Dysphagia is common in the last days of life (Bogaardt et al., 2015). Patients themselves, their families and caregivers, and health care professionals often struggle to deploy best practices in dysphagia management during this stage. Despite agreement that one's end-of-life should promote comfort, whether or not this is achieved can be unintentionally negatively impacted by the values of loved ones and health care workers, as well as health care workers' practice patterns. Importantly, we have yet to establish a comprehensive understanding of the patient experience at end-of-life to determine what truly entails “comfort” surrounding eating and drinking. Speech-language pathologists are increasingly consulted to address swallowing at end-of-life. It behooves the skilled clinician to have an understanding of the human condition in the final days to hours of life. Method In this piece, we explore the effects of food, drink, and the fasted state in both healthy adults and adults at end-of-life. We pose the thought-provoking question: Do food and drink contribute to a quality of death? Conclusion With this information, we work at the top of our license as providers who bring a unique, comprehensive understanding of such patients to the multidisciplinary comfort care team.

Publisher

American Speech Language Hearing Association

Subject

General Medicine

Reference33 articles.

1. Epidemiology And Patterns Of Care At The End Of Life: Rising Complexity, Shifts In Care Patterns And Sites Of Death

2. Metabolic effects of glucose in brief and prolonged fasted man

3. American Speech-Language-Hearing Association. (n.d.). End-of-life issues in speech-language pathology. https://www.asha.org/slp/clinical/endoflife/

4. Barratt J. (2017 February). We are living longer than ever. But are we living longer? https://www.statnews.com/2017/02/14/living-longer-living-better-aging/

5. Swallowing Problems at the End of the Palliative Phase: Incidence and Severity in 164 Unsedated Patients

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