Nutrition and hydration in dying patients: the perceptions of acute care nurses

Higgins, Isabel; Riet, Pamela van der; Sneesby, Ludmilla; Good, Phillip

doi:10.1111/jocn.12478

Cited by 15 publications

(33 citation statements)

References 29 publications

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“…Decisions about whether or not to use a feeding tube and other important end-of-life (EOL) considerations have never been simple. Debates and controversies over the functions and effectiveness of feeding tubes, particularly for older adults during EOL situations, have been frequently reported in literature (Higgins, Riet, Sneesby, & Good, 2014;Moran & O'Mahony, 2015). Concerns include health risks and complications, patients' discomfort with the procedure, and families' emotional difficulties and dissatisfaction with patient care.…”

Section: Introductionmentioning

confidence: 99%

“…Concerns include health risks and complications, patients' discomfort with the procedure, and families' emotional difficulties and dissatisfaction with patient care. Health care professionals are encouraged to have dialogue with patients and family regarding associated risks and benefits, as well as to elicit their preferences, needs, and concerns relating to feeding tubes (Austin, Mohottige, &Sudore, 2015;Higgins et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Preferences for Feeding Tube Use and Their Determinants Among Cognitively Intact Nursing Home Residents in Wuhan, China: A Cross-Sectional Study

Mao

2019

J Transcult Nurs

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Introduction: Standard advance care planning practice is yet to be established in Mainland, China, and little is known about feeding tube preferences among Chinese nursing home residents. The purpose of the study was to examine preferences for feeding tube use and its predictors among frail and cognitively competent nursing home residents in Wuhan, China. Method: A cross-sectional sample of 682 nursing home residents were interviewed face-to-face using a structured questionnaire from 2012 to 2014. Results: A total of 54.5% of participants would accept feeding tube. Participants who reported greater quality of life (odds ratio [OR] = 2.67), having health insurance (OR = 2.09) were more willing to accept feeding tube. Participants with greater impairment in physical health (OR = 0.94) were less willing to accept it. Discussion: Health care professionals need to routinely assess nursing home residents’ feeding tube preferences. It is imperative to consider sociocultural perspectives in understanding Chinese older adults’ decision making for end-of-life care.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preferences for Feeding Tube Use and Their Determinants Among Cognitively Intact Nursing Home Residents in Wuhan, China: A Cross-Sectional Study

Mao

2019

J Transcult Nurs

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“…In palliative patients, and especially end‐of‐life situations, the prescription and/or withdrawal of hydration has raised great concern among professionals and the wider public due to its clinical, ethical and legal significance, constituting one of the main dilemmas in decision‐making processes shared among patients, relatives and healthcare professionals (Gent, Fradsham, Whyte, & Mayland, ; Higgins, van der Riet, Sneesby, & Good, ; Río et al, ). The most recent reviews show that there is limited evidence to support the use of artificial hydration in improving sedation and myoclonus or reducing dehydration (Good, Richard, Syrmis, Jenkins‐Marsh, & Stephens, ), and artificial hydration may exacerbate symptoms associated with fluid retention, such as oedema, ascites, bronchial secretions and dyspnoea (Gent et al, ; Good et al, ; Nakajima, Satake, & Nakaho, ).…”

Section: Introductionmentioning

confidence: 99%

Availability and perceived usefulness of guidelines and protocols for subcutaneous hydration in palliative care settings

Cabañero‐Martínez

Ramos‐Pichardo

Velasco-Álvarez

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To evaluate the availability of, adherence to, and perceived usefulness of guidelines and protocols for managing hydration and subcutaneous hydration in palliative care settings. Background Hydration at the end of life and the use of a subcutaneous route to hydrate generate some controversy among health professionals for different reasons. Having guidelines and protocols to assist in decision‐making and to follow a standard procedure may be relevant in clinical practice. Design Cross‐sectional telephone survey, with closed‐ended and open‐ended questions designed specifically for this study. Methods Data were obtained from 327 professionals, each from a different palliative care service. Mean, standard deviation, minimum and maximum were calculated for continuous variables; frequency distributions were obtained for categorical variables. A qualitative content analysis was performed on the open‐ended questions. The article adheres to the STROBE guidelines for reporting observational studies. Results Only 24.8% of the participants had guidelines available to assist in making decisions regarding hydration, and 55.6% claimed to follow them ‘always or almost always’. Of the participants, 38.8% had subcutaneous hydration protocols available, while 78.7% stated that they ‘always or almost always’ followed these protocols. The remaining participants considered the protocols as useful tools despite not having them available. Conclusions Only 25% of the participants' services had guidelines for hydration, and less than 40% had protocols for subcutaneous hydration. However, adherence was high, especially in cases where protocols existed. Among the participants who did not have guidelines and protocols, attitudes were mostly favourable, but mainly as a reference and support for an individualised clinical practice. Relevance to clinical practice Guidelines and protocols on hydration in palliative care may be more useful as a solid reference and support for individualised practice than as instruments for standardising care. From this perspective, their development and availability in palliative care services are recommended.

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“…) for this patient group, in both acute care (Higgins et al . ) and advanced‐disease settings such as dementia care (Bryon et al . ).…”

Section: Introductionmentioning

confidence: 99%

“…A considerable body of research has examined the ethical ramifications of providing artificial hydration (AH) (Geppert et al 2010) for this patient group, in both acute care (Higgins et al 2014) and advanced-disease settings such as dementia care (Bryon et al 2012). Cochrane reviews have identified insufficient evidence for claims that AH in palliative care extends quality of life or life expectancy (Good et al 2008.…”

Section: Introductionmentioning

confidence: 99%

How and why are subcutaneous fluids administered in an advanced illness population: a systematic review

Forbat

Kunicki

Chapman

et al. 2017

Journal of Clinical Nursing

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Nutrition and hydration in dying patients: the perceptions of acute care nurses

Abstract: Nurses in acute care settings need to be involved in decision-making and advocate for patients and family during the dying phase. Nurses in acute care need better understanding about the palliative approach to care and nutrition and hydration for people who are dying.

Cited by 15 publications

References 29 publications

Preferences for Feeding Tube Use and Their Determinants Among Cognitively Intact Nursing Home Residents in Wuhan, China: A Cross-Sectional Study

Preferences for Feeding Tube Use and Their Determinants Among Cognitively Intact Nursing Home Residents in Wuhan, China: A Cross-Sectional Study

Availability and perceived usefulness of guidelines and protocols for subcutaneous hydration in palliative care settings

How and why are subcutaneous fluids administered in an advanced illness population: a systematic review

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