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Palliative care - fluid, food, and digestion

Alternative names

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

What it is

It is normal for a person who is dying to not feel like eating. A serious illness can cause body systems that manage fluids and food to change at this time. They can slow down and fail. Also, medicine that treats pain can cause dry, hard stools that are difficult to pass.

What you might feel

Loss of appetite

Trouble chewing, caused by:

  • Mouth or tooth pain
  • Sores in the mouth
  • Stiff or painful jaw

Constipation:

  • Fewer bowel movements than usual
  • Hard stool

Nausea:

  • Feeling sick to your stomach
  • Throwing up

What you might do

Fluids:

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

Food:

  • Cut food into small pieces and chew slowly.
  • Blend or mash foods so they don't need to be chewed much.
  • Eat food that is soft and smooth, like soup, yogurt, applesauce, or pudding.
  • Drink shakes or smoothies.
  • If you feel nauseated, eat dry, salty foods and clear liquids.

Digestion:

  • Write down the times when you have bowel movements.
  • Drink sips of water or juice at least every 2 hours while awake.
  • Eat fruit, especially prunes.
  • If possible, walk more.
  • When you try to have a bowel movement, sit on a toilet, commode, or bedpan.
  • Talk to someone on your health care team about stool softeners or laxatives.

When to call the doctor

Call your hospice nurse or doctor if you have nausea, constipation, or pain that cannot be managed.

References

Levine SK, Shega JW. What medications are effective in preventing and relieving constipation in the setting of opioid use? In: Goldstein NE, Morrison S. Evidence-Based Practice in Palliative Medicine. Philadelphia, PA: Elsevier Saunders; 2013:chap 24.


Review Date: 5/11/2014
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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