When someone enters hospice care, it’s natural for their eating and drinking habits to change. Often, they simply don’t want to eat or drink as much. This can be incredibly difficult for families and caregivers to witness.
This article aims to provide information and support to families navigating this challenging time. We’ll explore why decreased food and water intake is a normal part of the end-of-life process, how long someone in hospice might live without water, and most importantly, how to ensure their comfort.
Ultimately, hospice is about prioritizing comfort and quality of life. Understanding the role of hydration is a key part of providing the best possible care.
Why Hospice Patients Stop Eating and Drinking: A Natural Part of the Dying Process
It can be difficult to watch a loved one in hospice gradually lose their appetite and thirst. But often, this is a natural and unavoidable part of the dying process.
Physiological Reasons
As the body begins to shut down, its need for food and fluids decreases. The body shifts its focus away from sustaining life and toward minimizing discomfort. The underlying illness can also cause a loss of hunger and thirst signals.
Medical and Physical Factors
Fatigue and weakness can make it difficult for a hospice patient to eat and drink. Medications can also have side effects that reduce appetite and cause nausea. Physical discomfort, such as pain or difficulty swallowing, can also deter eating and drinking.
What Happens When a Hospice Patient Stops Drinking Water?
When someone in hospice stops drinking water, there are some predictable physical and mental changes that tend to occur.
Physical Changes
Dehydration is a natural consequence when fluid intake stops. This can lead to decreased urine output and a dry mouth. The patient may have less energy and feel more tired. Digestion will likely slow down as well.
Changes in Consciousness
As the body begins to shut down, there will likely be gradual changes in awareness, possibly leading to drowsiness or confusion.
It’s important to remember that these changes aren’t necessarily painful or distressing for the person who is dying. In fact, many people in hospice find that as they become less aware of what’s happening around them, they also feel less discomfort.
How long can a hospice patient live without water?
It’s impossible to give a precise answer, as survival time varies greatly. Many factors influence how long someone can live without fluids, including their underlying condition, their overall health, and their metabolism.
However, research suggests that most people can only survive a few days to a few weeks without water. Some studies have found that most individuals live about 10 days. In rare cases, some patients may survive for several weeks without food intake.
It’s important to remember that when someone is in hospice care, the priority shifts from extending life to maximizing comfort and quality of life. Focusing on the length of survival is less important than making sure the person is as comfortable and peaceful as possible.
Why forcing fluids can be harmful
It can be hard to watch someone you love stop eating and drinking, but at the end of life, trying to force fluids can be harmful.
Potential complications
Forcing someone to drink can cause them to feel uncomfortable, nauseated, and bloated. It can also increase the risk of fluid entering the lungs, which is known as pulmonary edema or aspiration.
Swelling (edema) and oxygen deprivation (hypoxia) are also possible.
Ethical considerations
At the end of life, it’s important to respect the patient’s wishes and allow the natural dying process to take its course.
Artificial nutrition and hydration may actually complicate the dying process and may not extend survival for hospice patients.
Providing comfort and support: Alternatives to hydration
When a loved one is nearing the end of their life, your focus will likely be on keeping them as comfortable as possible. Even if they can no longer take fluids, there are many ways to provide comfort and support.
Oral care
Frequent oral care can help keep the mouth moist. Use swabs or a damp cloth to gently moisten the lips, gums, and tongue. A little lip balm can prevent dryness and cracking.
If your loved one is able to swallow comfortably, you might offer ice chips or tiny sips of water.
Other comfort measures
The hospice team will likely have prescribed medications or other treatments to help manage pain and other symptoms. Be sure to follow their directions carefully.
A quiet, peaceful environment can be incredibly soothing. Play soft music, dim the lights, and keep the room at a comfortable temperature. Most importantly, be present and offer emotional support and companionship. Hold their hand, talk to them, or simply sit quietly by their side.
Frequently Asked Questions
What are the 4 stages of death in hospice patients?
While not everyone experiences them in the same way, the four stages are often described as: 1) the pre-active stage, where withdrawal and decreased appetite begin; 2) the active stage, marked by physical changes like altered breathing and skin color; 3) the transition, where breathing patterns change and the person may become unresponsive; and 4) the final hours, leading to death.
How long can a hospice patient live without water?
It’s tough to give an exact timeframe, as it varies depending on the individual’s overall health, age, and the underlying condition. Generally, a person might survive for several days without food, but the lack of water significantly shortens that period, potentially to a few days or less.
How many days without water is fatal?
Again, it’s highly individual. However, most healthy adults can only survive for approximately 3 to 5 days without water. For hospice patients who are already weakened, dehydration can accelerate the dying process considerably.
What are common symptoms in the last 48 hours of life?
Common symptoms in the last 48 hours often include changes in breathing patterns (like Cheyne-Stokes respiration), decreased responsiveness, a drop in blood pressure, changes in skin color (mottling), and restlessness. Hospice care focuses on managing these symptoms to ensure comfort.
Wrapping Up
Refusing food and water is often a natural part of the dying process when someone is in hospice care. The focus shifts to comfort, dignity, and emotional support for the person who is dying and for their loved ones.
If your family member is in hospice care and stops eating or drinking, it’s important to work closely with the hospice team. Together, you can create a care plan that honors your loved one’s wishes and values and helps them stay as comfortable as possible during their final days.