End of life feeding: which way?
Keywords:
Food, Terminal ill, Palliative careAbstract
Food is permanently present in our lives, necessary for reasons of survival and guided by psychological, socio-cultural and spiritual aspects. Due to the advancement of the disease and the dietary changes that arise at this stage of life, food becomes even more complex and is often a topic of controversy between the sick person, the family and health professionals, namely the nurse, who is present at all times related to this life activity (AL). Dietary changes often lead to the questioning of those involved about the most appropriate interventions and pondering the use of artificial nutrition and hydration. This article presents a critical analysis based on a review of the literature on eating disorders and the artificial eating and hydration controversy at this stage of life, reflecting the complexity of this phenomenon. It is concluded that end-of-life feeding should be an individualized process whit the person, maximizing comfort.
Downloads
References
Acreman, S. (2009). Nutrition in palliative care. British Journal of Community Nursing, 14(10), 427-431. DOI: http://dx.doi.org/10.12968/bjcn.2009.14.10.44494.
Also, S. (2014). Artificial nutrition and hydration. In B. Jennings (Ed.). Bioethics (4th edition, p. 284-289). EUA: Gale, Cengage Learning.
American Academy of Hospice and Palliative Medicine (2013). Statement on artificial nutrition and hydration near the end of life. Consultado em outubro, 2019, em http://aahpm.org/positions/anh.
ARSLVT (2017). Comissão de ética para a saúde da ARSLVT: Proposta de parecer sobre consentimentos informados (CI) na perspetiva da RNCCI. Consultado em agosto, 2018, em https://www.arslvt.min-saude.pt/uploads/writer_file/document/5023/Consentimentos_Informados__%20CI__na_perspetiva%20da_RNCCI.pdf.
Baracos, V. (2013). Clinical trials of cancer cachexia therapy, now and hereafter. Journal of Clinical Oncology, 31(10), 1257–1258. DOI:10.1200/JCO.2012.48.3149.
Barbosa, A. (2003). Pensar a morte nos cuidados de saúde. Análise Social, 38 (166), 35-49. Consultado em outubro, 2019, em http://analisesocial.ics.ul.pt/documentos/1218737559Q5dRD9fa3Zz85OZ8.pdf.
Beauchamp, T. & Childress, J. (2011). Princípios de ética biomédica. (2ª edição). São Paulo: Edições Loyola.
Benarroz, M., Faillace, G. & Barbosa, L. (2009). Bioética e nutrição em Cuidados Paliativos oncológicos em adultos. Cadernos de Saúde Pública, 25 (9), 1875-1882. DOI: http://dx.doi.org/10.1590/S0102-311X2009000900002.
Bezerra do Amaral, J., Menezes, M., Martorell-Poveda, A. & Passos, S. (2012). Ethic and bioethic dilemmas on palliative care for hospitalized elderly: nurses’ experience. Cultura de los cuidados, 16 (33), 14-21. DOI: 10.7184/cuid.2012.33.02.
Botejara, I. & Neto, I. (2016). Hidratação e nutrição em fim de vida. In A. Barbosa, P. Pina, F. Tavares & I. Neto (Eds), Manual de Cuidados Paliativos (3ª edição, p. 331-344). Lisboa: Faculdade de Medicina da Universidade de Lisboa.
Bozzetti F., Arends J., Lundholm K., Micklewright A., Zurcher G., & Muscaritoli M. ... (2009). ESPEN guidelines on parenteral nutrition: nonsurgical oncology. Clinical Nutrition, 28, 445–454. DOI: 10.1016/j.clnu.2009.04.011.
Bruera E., Hui D., Dalal S., Torres-Vigil I., Trumble J., … & Tarleton K. (2013). Parenteral hydration in patients with advanced cancer: A multicenter, double-blind, placebo-controlled randomized trial. Journal of Clinical Oncology, 31(1), 111-118. DOI: 10.1200/JCO.2012.44.6518.
Bryon, E., Gastmans, C. & De Casterlé, B. (2008). Decision-making about artificial feeding in end-of-life care: literature review.
Journal of Advanced Nursing, 63(1), 2-14. DOI: 10.1111/j.1365-2648.2008.04646.x.
Capelas, M., Coelho, S., Silva, S. & Ferreira, C. (2017). Cuidar a pessoa que sofre: uma teoria de Cuidados Paliativos. Lisboa: Universidade Católica Editora.
Carvalho, R. & Taquemori, L. (2008). Nutrição e hidratação. In A. de Oliveira (Coord.), Cuidado paliativo (pp. 221-257). S. Paulo: Conselho Regional de Medicina do Estado de São Paulo.
Druml, C., Ballmer, P., Druml, W., Oehmichen, F., Shenkin, A., & Stephan C. ... (2016). ESPEN guideline on ethical aspects of artificial nutrition and hydration. Clinical Nutrition, 35(3), 545-556. DOI: http://dx.doi.org/10.1016/j.clnu.2016.02.006.
Easson, A., Hinshaw, D. & Johnson D. (2002). The role of tube feeding and total parenteral nutrition in advanced illness. Journal of the American College of Surgeons, 194, 225–228. DOI: https://doi.org/10.1016/S1072-7515(01)01154-1.
Ferrell, B. (2006). Understanding the Moral Distress of Nurses Witnessing Medically Futile Care. Oncology Nursing Forum, Sep, 33(5), 922-30. DOI:10.1188/06.ONF.922-930.
Fuhrman, P. & Herrmann, V. (2006). Bridging the continuum: nutrition support in palliative and hospice care. Nutrition in Clinical Practice, 21, 134–141. DOI: 10.1177/0115426506021002134.
Ganzini L., Goy E., Miller L., Harvath T., Jackson A., … & Delorit M. (2003). Nurses’s experiences with hospice patients who refuse food and fluids to hasten death. The New England Journal of Medicine, 349, 359-65. DOI: 10.1056/NEJMsa035086.
General Medical Council (2010). Treatment and care towards the end of life: good practice in decision making. Consultado em outubro, 2019, em http://tinyurl.com/lgrq7qn.
Gillespie, L. & Raftery, A. (2014). Nutrition in palliative and end-oflife care. Nutrition and palliative care, July, 15-20. DOI: 10.12968/bjcn.2014.19.Sup7.S15.
Good, P., Richard, R., Syrmis, W., Jenkins-Marsh, S. & Stephens, J. (2014). Medically assisted hydration for adult palliative care patients (review). Cochrane Database of Systematic 2014, 4, 1-27. DOI:10.1002/14651858.CD006273.pub3.
Greenberger, C. (2015). Enteral nutrition in end of life care: The Jewish Halachic ethics. Nursing Ethics, 22(4), 440–451. DOI:
1177/0969733014538891.
Hoda D., Jatoi A., Burnes J., Loprinzi C. & Kelly D. (2005). Should patients with advanced, incurable cancers ever be sent home with total parenteral nutrition? Cancer, 103, 863–868. DOI: 10.1002/cncr.20824.
Holder, H. (2003). Nursing management of nutrition in cancer and palliative care. British Journal of Nursing, 12 (11), 667-674. DOI:10.12968/bjon.2003.12.11.11316.
Holmdahl, S., Sävenstedt, S. & Imoni, R. (2014). Parenteral nutrition in home-based palliative care: Swedish district nurses experiences. Scandinavian Journal of Caring Sciences, 28, 89–96. DOI: 10.1111/scs.12038.
Iliescu, A. & Cotoi, B. (2013). Patient’s nutrition in palliative care: Ethical values. Current Health Sciences Journal, 39 (3), 184-186. Consultado em agosto, 2019, em https://www.chsjournal.org/CHSJ/papers/CHSJ.39.03.11.pdf.
Lei nº 31/2018 de 18 de julho (2018). Lei dos direitos das pessoas em contexto de doença avançada e em fim de vida. Diário da República I Série n.º 137 (18-07-2018) 3238-3239.
Mirhosseini N., Fainsinger R. & Baracos V. (2005). Parenteral nutrition in advanced cancer: indications and clinical practice
guidelines. Journal of Palliative Medicine, 8, 914–8. DOI: https://doi.org/10.1089/jpm.2005.8.914.
Morss, S. (2006). Enteral and parenteral nutrition in terminal ill cancer patients: A review of the literature. American
journal of Hospice &Palliative care, 23 (5), 369-377. DOI:10.1177/1049909106292167.
Neto, I. (2016). Cuidados Paliativos: princípios e conceitos fundamentais. In A. Barbosa, P. Pina, F. Tavares & I. Neto (Eds).
Manual de Cuidados Paliativos (3ª edição, pp. 1-22). Lisboa: Faculdade de Medicina de Lisboa.
O’Connor, M. (2007). ‘I’m just not interested in eating’: When nutrition becomes an issue in palliative care. Contemporary Nurse: A Journal for the Australian Nursing Profession, 27(1), 23-28. DOI:10.5555/conu.2007.27.1.23.
Pinto, C. (2009). Procedimentos sustentadores de vida em Cuidados Paliativos: Uma questão técnica e bioética. In Academia Nacional de Cuidados Paliativos (ed.). Manual de Cuidados Paliativos, (pp.195-201). Rio de Janeiro: Diagraphic.
Piot, E., Leheup, B., Goetz, C., Quilliot, D., Niemier, J., & Ducrocq, X. ... (2015). Caregivers confronted with the withdrawal of artificial nutrition at the end of life: Prevalence of and reasons for experienced difficulties. American Journal of Hospice & Palliative Medicine, 32(7), 732-737. DOI: 10.1177/1049909114539037.
Planas M. & Camilo M. (2002). Artificial nutrition: dilemmas in decision-making. Clinical Nutrition, 21, 355–361. DOI: https://doi.org/10.1054/clnu.2002.0549.
Raijmakers, N., Van Zuylen, L., Constantini, M., Caraceni, A., Clark, J., & Van der Heide, A. … (2011). Artificial nutrition and hydration in the last week of life in cancer patients. A systematic literature review of practices and effects. Annals of Oncology, 22 (7), 1478–1486. DOI:10.1093/annonc/mdq620.
Resende, R. (2009). Alimentar no final da vida: Transição do familiar cuidador para a recusa alimentar. (Dissertação de Mestrado). Universidade Aberta, Lisboa.
Stepp L. & Pakiz T. (2001). Anorexia and cachexia in advanced cancer. Nursing Clinics of North America, 36 (4),735-44. Consultado em outubro, 2019, em https://www.ncbi.nlm.nih.gov/pubmed/11726350.
Stern, P. (2009). In the beginning Glaser and Strauss created Grounded Theory. In J. Morse, P. Stern, J. Corbin, B. Bowers, K.
Charmaz & A. Clarke. Developing grounded theory: The second generation, (pp. 24-29). California: Left Coast Press Inc.
Strasser, F., Cerny, T., Binswange, J. & Kesselring, A. (2007). Fighting a losing battle: eating related distress of men with advanced cancer and their female partners. A mixed-methods study. Palliative Medicine, 21, 129-137. DOI:10.1177/0269216307076346.
Therapeutic Guidelines in Palliative Care (2005). Therapeutic Guidelines Limited Melbourne (2nd version). Consultado em outubro, 2019, em http://www.tg.org.au/index.php?sectionid=47.
Valentini, E., Giantin, V., Voci, A., Iasevoli, M., Zurlo, A., & Manzato, E. ... (2014). Artificial nutrition and hydration in terminally ill patients with advanced dementia: Opinions and correlates among italian physicians and nurses. Journal of Palliative Medicine, 17 (10), 1143-1149. DOI: 10.1089/jpm.2013.0616.
Van der Riet, P., Good, P, Higgins, I. & Sneesby, L. (2008). Palliative care professionals’ perceptions of nutrition and hydration at the end of life. International Journal of Palliative Nursing, 14 (3), 145-151. DOI: 10.12968/ijpn.2008.14.3.28895.
Van der Riet, P., Higgins, I., Good, P., & Sneesby, L. (2009). A discourse analysis of difficult clinical situations in relation to nutrition and hydration during end of life care. Journal of Clinical Nursing, 18(14), 2104-2111. DOI: 10.1111/j.1365-2702.2008.02760.x.
Verhofstede, R., Smets, T., Cohen, J., Eecloo, K., Costantini, M., & Deliens, L. ... (2017). End-of-life care and quality of dying in 23
acute geriatric Hospital Wards in Flanders, Belgium. Journal of Pain and Symptom Management, 53 (4), 693-702. DOI:10.1016/j.jpainsymman.2016.10.363.
Winter S. (2000). Terminal nutrition: framing the debate for the withdrawal of nutritional support in terminally ill patients. The American Journal of Medicine, 109, 723 – 726. DOI: 10.1016/S0002-9343 (00) 00609-4.
Zanuy, M., Nido, R., Rodriguez, P., González, R., Villares, J. & Sanz, M. (2006). Se considera la hidratacion y la nutricion artificial como un cuidado paliativo? Nutrición Hospitalaria, 21(6), 680-685. Consultado em outubro, 2019, em http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112006000900008.
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Patrícia Vinheiras Alves, Célia Simão Oliveira, Marta Lima Basto
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
