NYT: Minimal Comfort Feeding for late-stage patients

dancsfo

A controversial issue: "Some consider the regular feeding of late-stage dementia patients to be nonnegotiable. Others see it as extending life unnecessarily."

Shared gift link.

SusanB-dil

Very interesting… 'minimal comfort feeding'. Much to think on with this.

What comes to mind is Wendy Mitchell's situation. She sort-of did just this, herself… To me, that says a lot.

Maru

https://alzconnected.org/discussion/76496/nyt-minimal-comfort-feeding-for-late-stage-patients

I have a couple of thoughts here. Starvation is uncomfortable at best and painful at worst. Dehydration can quickly lead to urinary tract infections which are not pleasant. I would not wish to do that to my LO. That is not to say late-stage PWD should have IVs and tube feedings, or even forced feeding, all of which I would be against. When/if my DH lives long enough to be in late-stage. Food and liquids will be offered as usual, but none will be forced on him.

Ultimately, every caretaker has to find what they can live with.

ARIL

A friend of mine in her 40s had a terminal illness involving a great deal of pain. She consciously elected VSED (Voluntarily Stopping Eating and Drinking) while under hospice care. I had not heard of that before. They told her it would take no more than three weeks; she lived two months. It was difficult. But the key point for me is that she had no cognitive problems and made these decisions for herself—including making some choices to get off the VSED plan a time or two.

It feels ethically very different to hasten death in this way for someone else. But determining what real “comfort care” looks like in specific situations is not easy.

terei

My mother was clear with me that if she could no longer feed herself, she did not want to be ‘fed like a baby’. We respected her wished. I demanded that she stopped being awakened for meals (she kept falling asleep right into her plate in the dining room). I also would not allow her to be fed. If she did not pick the food up and eat it, she didn’t eat. She was under hospice care. After much back and forth with the facility about feeding her, I told them I was removing her from their care to take her home to my daughter’s who lived near there and I moved into her room at the MC and supervised her care 24/7 I was there about 8 days and she died the day before the date we were moving her. Hand feeding IMO is usually extending the LO’s life artificially when their quality of life is nil. Ditto any idea of a feeding tube which has been shown not to extend the PWD life anyway. (Feeding tubes are almost never suggested these days in any case)

JulietteBee

That is certainly a different perspective. As a nurse, I would balk at a request not to feed one of my patients. However, if allowed to take my cues from said patient, that would be more palatable a task than starvation.

SusanB-dil

It is also a matter of not 'pure starvation', but rather, comfort feeding when needed - and only after it gets to the point that they may have agreed on previous, as with terei. @terei , thank you very much for this input.

I would not be able to allow someone to just outright starve, either. I'm sure that as caregivers, to do that would go against everything we strive toward. and to keep our LO hydrated…