Assisted nutrition and fluids
Assisted nutrition and fluids are only provided when someone is completely unable or unwilling to eat or drink. At the end of someone's life, it's quite natural for them to stop wanting to eat or drink. Those close to the person can find this difficult to accept and sometimes ask for their relative or friend to be artificially fed.
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There are times when it’s essential to have assisted nutrition and fluids, but there can be disadvantages. Medical professionals will assess your needs to find the best course of action.
If you’re approaching the last days or weeks of life, it’s important for your doctor to involve you in any decision about assisted nutrition and fluids. This is because you may not want to be fed artificially or have your life prolonged.
- You find it difficult or impossible to swallow.
- You’re vomiting.
- You’re not absorbing your food properly – this may occur with some illnesses of the bowel.
- You’re losing weight and/or becoming very weak.
Tip: if you have a dry or sore mouth, try sucking ice granules, peppermints, or boiled sweets.
- Artificial fluid can make you want to pass urine more often.
- The tubes can be uncomfortable.
- Feeding might make you feel sick or vomit – people can sometimes be overloaded with fluids when they’re in their final days or weeks.
- If someone is unable to make decisions for themselves, they may be unhappy about being connected to feeding and nutrition tubes.
- Seeing someone with tubes up their nose can be upsetting, but tubes can also be inserted directly into the stomach through a small incision.
If you’re a carer, you may feel that the one thing you can do for the person you’re looking after is cook them meals. When mealtimes are taken away it removes the sociability of sitting together to eat. It also impacts on feelings that you’re ‘not doing enough’ for your relative or friend.
In most cases assisted nutrition and fluids will be avoided until absolutely necessary. If the medical team decide that it’s the only option, it can be upsetting for you as a carer. You may need support or counselling to help you face this new stage.
It can seem daunting to have artificial nutrition and hydration systems at home. The medical team will set up the system, provide the food and make sure that you and your carer are confident about how everything works before assisted nutrition and fluids are started.
There are two types:
- Enteral feeding through tubes, which go directly into the stomach and the intestines. This can be set up at home.
- Parenteral feeding involves supplying nutrition intravenously, and has to be controlled in a hospital setting. Occasionally this kind of feeding might be possible in the home. Ask your Marie Curie Nurse or district nurse for details.
This type of feeding involves tubes which go up the nose and down into the stomach. Training on how to insert these is required because if a tube comes loose or moves out of place and into the lungs, it can be dangerous.
The tubes can lead directly into the stomach or small intestines, but a small surgical procedure is needed in hospital to insert them. This has the advantage of not looking so obvious or distressing to visitors and family.
Sometimes liquid medicines may be added to fluids.
This is where intravenous drips go directly into a main vein, and have to be monitored closely in hospital.
Subcutaneous infusion delivers fluids through a fine tube or needle under the skin, and occasionally this is set up in the home.
For help with assisted nutrition and fluids, contact your doctor, district or Marie Curie Nurse or dietician. There is also a regional support group for people using assisted nutrition and fluids, called Patients on Intravenous and Nastro-gastric Therapy (PINNT ).
This page is for general information only. It's not intended to replace any advice from health or social care professionals. We suggest that you consult with a qualified professional about your individual circumstances. Read more about how our information is created and how it's used.
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