Message Font: Serif | Sans-Serif
 
UnThreaded | Threaded | Whole Thread (21) | Ignore Thread Prev | Next
Author: xraymd Big gold star, 5000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 121219  
Subject: Re: Unexpected windfall Date: 6/24/2007 12:10 PM
Post New | Post Reply | Reply Later | Create Poll . Report this Post | Recommend it!
Recommendations: 35
Greetings, Wendy and Phil, this is how I regularly witness the end of life once someone has become unable to eat or drink - either they are largely somnolent and sleeping for great stretches of time or to take in nutrition and fluids actually makes them feel worse (nausea in a kidney failure patient because the kidneys can no longer filter the toxins that the body creates as byproducts of processing nutrients).

In a patient who is awake and able to eat and drink, by all means is this continued and NOT withheld! When nutrition and fluids are withheld is when a patient has ALREADY become unable to take them in independently (someone who has become dependent on tube feeds, for instance, who has been rendered unable to swallow due to stroke, esophageal stricture or bowel obstruction likely from cancer, unremitting nausea from numerous processes) and who is clearly made less comfortable by being given such nutrition. Why near the end it becomes adverse to continue trying to feed and hydrate is that when the organs begin to shut down, the body struggles to metabolize the intake with much lower reserves and this puts a strain on the processes that are already diminished. The patients refusal of food and water is instinctive.

In Hospice, nutrition and hydration are offered but not foisted. The patient guides the staff by ceasing to seek food over time. Mouth swabs and ice chips are always available to moisten but the sensation of raging hunger or thirst appears to just dissipate. Unlike in health! So one of the major misconceptions about standing guard when someone is dying is that somehow they must be hungry or thirsty and must be fed and hydrated at all costs. I have seen patients whose families insisted on this literally yank out their IV or their feeding tube with some of their last remaining strength. So I have learned to respect that, when the time comes, the patient will choose not to continue with nutrition or hydration because they simply feel better without it. Sometimes that choice is made alertly and sometimes it is when the patient has begun to sleep for longer and longer stretches (dehydration particularly confers somnolence as the kidneys invariably shut down) and this ends up being among the more calm and tranquil ways to pass.

xraymd
Post New | Post Reply | Reply Later | Create Poll . Report this Post | Recommend it!
Print the post  
UnThreaded | Threaded | Whole Thread (21) | Ignore Thread Prev | Next

Announcements

Disclaimer:
In accordance with IRS Circular 230, you cannot use the contents of any post on The Motley Fool's message boards to avoid tax-related penalties under the Internal Revenue Code or applicable state or local tax law provisions.
Pencils of Promise - Back to School Drive
"Pencils of Promise works with communities across the globe to build schools and create programs that provide education opportunities for children."
Managing Your Wealth
Our own TMFHockeypop from Rule Your Retirement fame on the TV show Managing Your Wealth.
When Life Gives You Lemons
We all have had hardships and made poor decisions. The important thing is how we respond and grow. Read the story of a Fool who started from nothing, and looks to gain everything.
Post of the Day:
Apple

The Saddest Place on iPhone Day
What was Your Dumbest Investment?
Share it with us -- and learn from others' stories of flubs.
Community Home
Speak Your Mind, Start Your Blog, Rate Your Stocks

Community Team Fools - who are those TMF's?
Contact Us
Contact Customer Service and other Fool departments here.
Work for Fools?
Winner of the Washingtonian great places to work, and "#1 Media Company to Work For" (BusinessInsider 2011)! Have access to all of TMF's online and email products for FREE, and be paid for your contributions to TMF! Click the link and start your Fool career.
Advertisement