For a terminally ill patient with swallowing difficulties who cannot tolerate oral intake, what is the appropriate approach?

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Multiple Choice

For a terminally ill patient with swallowing difficulties who cannot tolerate oral intake, what is the appropriate approach?

When a terminally ill patient cannot swallow or tolerate food, the priority becomes comfort and aligning care with the patient’s goals. The best approach is to have a goals-of-care discussion with the patient and family, determine what level of intervention is desired, and plan around comfort-focused measures. Evaluate non-oral routes for hydration and symptom relief and address feeding in a way that minimizes burden and potential distress. Avoid invasive feeding measures like feeding tubes or forcing intake, since they often do not improve comfort or prognosis and can reduce quality of life. If the patient desires hydration for comfort, provide palliative hydration through acceptable routes, respecting the patient’s wishes. This approach centers on reducing suffering, preserving dignity, and supporting the chosen goals of care.

When a terminally ill patient cannot swallow or tolerate food, the priority becomes comfort and aligning care with the patient’s goals. The best approach is to have a goals-of-care discussion with the patient and family, determine what level of intervention is desired, and plan around comfort-focused measures. Evaluate non-oral routes for hydration and symptom relief and address feeding in a way that minimizes burden and potential distress. Avoid invasive feeding measures like feeding tubes or forcing intake, since they often do not improve comfort or prognosis and can reduce quality of life. If the patient desires hydration for comfort, provide palliative hydration through acceptable routes, respecting the patient’s wishes. This approach centers on reducing suffering, preserving dignity, and supporting the chosen goals of care.

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