How to manage terminal dehydration

Dehydration: Therapeutic at the End of Life

“…[1][2][3]6,13,14 To decrease or terminate hydration and/or nutrition is to be considered when there is no evidence that it restores quality to life. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] That mandates communication among patients, their family, and doctors. This is especially true when hydration promotes greater discomfort without likely recovery.…”

“…There also is a universal wish to extend enjoyable lives, but not to prolong unpleasant deaths. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] There are times when full hydration is not desirable, counterproductive, or detrimental. For selected patients who are dying, there may be a comfort benefit by allowing some degree of dehydration.…”

“…This is especially true when hydration promotes greater discomfort without likely recovery. 10,11,16 For some sick people, being less than fully hydrated can attenuate nausea, vomiting, or diarrhea. 6,[10][11][12][13] With lower volumes of urine and feces, incontinence diminishes somewhat, and this minimizes skin breakdown.…”

“…14 In addition, terminally ill people may choose dehydration as a method to shorten their lives. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] It is a physician's obligation to honor patient autonomy over such choices. 2,11 Every decisional person has this right, regardless of family or physician feelings during palliative circumstances.…”

“…For selected patients who are dying, there may be a comfort benefit by allowing some degree of dehydration. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Choosing elective dehydration can be a caring way to diminish discomfort. [1][2][3]6,[11][12][13][14] Avoiding fluids also can be a means of shortening the process of dying.…”