The Concept of Cachexia-Related Suffering (CRS) in Palliative Cancer Care

Oberholzer, Rolf; Blum, David; Strasser, Florian

doi:10.1201/b10936-26

Cited by 1 publication

(1 citation statement)

References 15 publications

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“…In terms of considering the use of CANH in the dying patient, it is important to try to identify when a patient's body is starting to shut down because of disease and the dying process. Anorexia and cachexia tend to ensue; at this point, nutritional support is normally not beneficial, since nutrients are no longer metabolized as before, 8 and patients generally do not experience hunger or thirst. Patients, especially those with cortical degeneration, are often unable to eat due to dysphagia.…”

Section: Mechanismmentioning

confidence: 99%

To What Extent Does Clinically Assisted Nutrition and Hydration Have a Role in the Care of Dying People?

Carter

2020

J Palliat Care

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The question over whether to administer clinically assisted nutrition and hydration (CANH) to a dying patient is controversial, with much debate concerning this sensitive issue. The administration of CANH poses clinical and ethical dilemmas, with supporting and opposing views. Proposed positive effects of CANH include preventing thirst, delirium, hypercalcemia, and opioid toxicity. However, CANH has been shown to increase the risk of aspiration, pressure ulcers, infections, and hospital admissions as well as potentially causing discomfort to the patient. Guidance from several national bodies generally advises that the risks and burdens of CANH outweigh the benefits in the dying patient. However, an individualized approach is needed, and the patient’s wishes regarding CANH need consideration if they have capacity and can communicate. Otherwise, sensitive discussions are required with the family, enquiring about the patient’s prior wishes if there is no advanced care plan and acting in the patient’s best interests. The ethical principles of autonomy, beneficence, non-maleficence, and justice need to be applied being mindful of any cultural and religious beliefs and potential misperceptions.

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Section: Mechanismmentioning

confidence: 99%