ABOUT THIS COURSE:
Artificial nutrition and hydration (ANH) can be a contentious issue in hospice, palliative care, and long-term care. This medical treatment has been identified as one of the most common ethical dilemmas to arise in end-of-life care. That there may be burdens associated with ANH is easily misunderstood by families, and feelings about ANH are often enveloped in cultural and spiritual concerns. After all, food and water are basic human needs that symbolize caring and nurturing. The possibility of withholding food and water seems cruel to families and may appear to hasten death. Not only families, but also medical staff, may have ethical concerns over not providing ANH to patients approaching the end of life. The reality of ANH is often very different from the perception. Certain methods of providing ANH are invasive medical procedures that increase risks of infection. Nausea, diarrhea edema, and aspiration, and other complications can occur with ANH. Because patients may have altered mental status at the time, it might be necessary to use restraints to keep patients from trying to disconnect the tubes providing nutrition and hydration. As the patients systems are deteriorating, the value of such measures may be questioned. In fact, studies show that at the end of life, artificial nutrition and hydration may neither prolong life nor offer comfort. This educational program presents the medical, legal, and ethical issues, and the communication barriers, that surround ANH. It will emphasize the need for end-of-life provider organizations to have clear and transparent policies on ANH and to offer training to staff and education for families to minimize family misunderstanding and discord as well as moral distress and anguish of staff.