Self Directed Learning Package - University of Queensland

144 • The Palliative Approach ToolkitArtificial hydration is usually administered via a small cannulaplaced under the skin (a subcutaneous SC drip). Althoughartificial hydration can be useful to treat reversible causes ofdehydration, it is not normally used when a resident is expectedto die within 48 - 72 hours.Thinking PointThink about how you feel if you forget to have a drinkduring your eight hour shift at work. Do you feel alittle drowsy, have a headache, dry mouth or dizzinessif you stand up quickly? Perhaps you just feel thirsty.Having a drink makes you feel better because itmoistens your mouth.Similarly, moistening the mouth of a resident who can no longerswallow fluids will keep them comfortable as much as or moreso than a ‘drip’.Key PointMedication side effects, oxygen therapy andmouth breathing can cause a dry mouth. Artificialhydration does not usually relieve the feeling ofdry mouth and can actually worsen respiratorysecretions, incontinence, vomiting, swelling(oedema) or breathing difficulties.WriteDocument your actionsMany residential aged care facilities expect careworkersto document information on assessment charts and in theclinical record. If this is part of your role, try and avoid generalstatements. Be as specific as possible.Avoid general statementsPOOR COMMUNICATIONGOOD COMMUNICATIONEvaluation of artificial hydration ‘with ‘Resident denies thirst or discomfort,effect’ or ‘effective’.mouth moist and intact, urinary outputstill moderate’.ReviewEvaluate and reassess as necessaryJust because artificial nutrition or hydration has been started doesnot mean that it should be continued until the resident dies.Artificial hydration needs to be reviewed regularly by the nurseand doctor to ensure it is still the most appropriate interventionfor the resident. In the terminal phase, assessment shouldoccur daily.You will learn more about the importance of oral care in a latersection of this learning package.