Nursing intervention when caring the terminal patient with changes in eating and drinking

Abstract

This article is a systematic literature review report (SLR) and focuses on nursing intervention in terminally ill patients with changes in eating and drinking. As the terminal illness progresses there is a continuing deterioration in the patient’s condition and as end of life approaches a lack of interest and refusal in eating and drinking is noted. However, in most cultures, eating and drinking have a symbolic life representation. A decrease is associated with death. In most cases, families are not prepared to deal with this situation, they persuade and demand the health professionals and the patient himself to maintain the intake of food and beverage intake, despite the patient’s refusal, leading to increased patient and family anxiety during meals. The aim of this SLR is to understand the
scientific evidence of nursing intervention in terminally ill patients with changes in eating and drinking, following the PICO method according to Joanna Briggs Institute (2008). Applying the defined inclusion and exclusion criteria, 4 studies were selected and analyzed and two themes emerged: the nursing intervention in the decision making regarding artificial feeding and nutrition and the nurse intervention in assessment and monitoring of the terminally ill patient with changes in eating and drinking. The results of this review suggest that scientific research on nursing intervention in terminally ill patients with changes in eating and drinking is essentially qualitative, based on nurses’ perceptions and opinions about the above mentioned themes. Also, the conditions in
which nursing interventions in this area occur, as well as their results, are not known; therefore it is concluded that it is an area of knowledge that merits investigation. Regarding the changes in eating and drinking, a gap emerges between the terminally ill patient and his family´s needs, raising the need to explore the process of caring the terminally ill patient with changes in eating and drinking and his family. Another issue that arises from this SLR is the need to explore the reasons that justify why nurses experience difficulty in approaching the weight loss subject with terminally ill patients. Besides the scarce research in this area and unclear nursing interventions, in this SLR also became apparent that nurses play a significant role in the decision-making process regarding artificial feeding and hydration of the terminal patient, and in supporting, guiding and informing the patient and family. Nurses consider this a very important role.