Self Directed Learning Package - University of Queensland

35 • Self Directed Learning Package - Introductory Registered & Enrolled NurseNutrition andhydrationOne of the big worries that Alfred’s daughter, Sarah, had at thepalliative care case conference was that Alfred might starve todeath if he is unable to eat and drink. Remember that Sarah’smother was fed through a gastrostomy tube after she hada stroke. This continued for three weeks before she died ofpneumonia.SeeRecognise and assessAlfred is drowsy and needs prompting to accept a drink from acup and straw.He only eats a few mouthfuls of food and sometimes coughswhen he swallows. Alfred is dying and this is causing his eatingand drinking problems. This is often a difficult and emotionaltime for families and can sometimes be hard for staff to manage.Key PointAt the end of life the body is beginning to shutdown because of the dying process, not because ofthe absence of food and fluids.Family members often find it difficult to distinguishbetween ‘not eating as part of the dying process’and ‘not eating as bringing about the dyingprocess’.