Palliative care

Constipation - palliative care; End of life - digestion; Hospice - digestion

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Description

People who have a very serious illness or who are dying often don't feel like eating. Body systems that manage fluids and food may change at this time. They can slow and fail. Also, some medicines that treat pain can cause dry, hard stools that are difficult to pass.

Palliative care is a holistic approach to care that focuses on treating pain and symptoms and improving quality of life in people with serious illnesses and a limited life span.

When Your Body has Problems Handling Fluids and Food

A person who is very sick or dying may experience:

Loss of appetite
Trouble chewing, caused by mouth or tooth pain, mouth sores, or a stiff or painful jaw
Constipation, which is fewer bowel movements than usual or hard stools
Nausea or vomiting

What you can do to Feel Better

These tips may help relieve discomfort due to loss of appetite or problems eating and drinking.

Fluids:

Sip water at least every 2 hours while awake.
Fluids can be given by mouth, through a feeding tube, through a tube that goes into a vein (intravenous; IV), or through a needle that goes under the skin (subcutaneous).
Keep the mouth moist with ice chips, a sponge, or oral swabs made for this purpose.
Talk to someone on the health care team about what happens if there is too much or too little fluid in the body. Decide together whether the person needs more fluids than they are taking in.

Food:

Cut food into small pieces.
Blend or mash foods so they don't need to be chewed much.
Offer food that is soft and smooth, like soup, yogurt, applesauce, or pudding.
Offer shakes or smoothies.
For nausea, try dry, salty foods and clear liquids.

Digestion:

If needed, write down the times the person has bowel movements.
Sip water or juice at least every 2 hours while awake.
Eat fruit, such as prunes.
If possible, walk more.
Talk to someone on the health care team about stool softeners or laxatives.

When to Call the Doctor

Contact a member of the health care team if nausea, constipation, or pain cannot be managed.

References

Arnold RM, Kutner JS. Palliative care. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 3.

House SA. Palliative and end-of-life care. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2024. Philadelphia, PA: Elsevier; 2024:42-48.

Shah AC, Gebauer S. Palliative care. In: Pardo M, ed. Miller's Basics of Anesthesia. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 47.

Review Date: 3/11/2024

Reviewed By: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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