Introduction
The RCP have recently updated their guidance document for supporting people who have eating and drinking difficulties, particularly at end of life, which aims “to guide an approach to finding a way through these difficulties that is legally sound, pragmatic and compassionate”. “The difficulties, uncertainties and confusion associated with decisions regarding provision of nutrition and hydration towards the end of life remain extremely challenging”. “In most cases there are no easy answers but rather approaches to follow to reach the best decision for each individual patient” (RCP, 2021).
RCP Report of a working party, Supporting people with eating and drinking difficulties. March 2021. Link to RCP report.
- Decisions about nutrition and hydration can cause dilemmas and differences of opinions between professionals and families. Everyone understands that receiving nutrition and hydration is essential to life and therefore failure to adequately address and explain the issue can result in lack of nutrition and hydration being blamed for the person’s deterioration
- Decisions about nutrition and hydration often run in parallel with decisions on overall prognosis and therefore may change and risk giving mixed messages if there is poor communication within the team and with the family
- Discussions need to take account of previous explanations given and attempt to understand the perspectives of the people involved
- Families and the healthcare team will require practical advice and support to manage oral care and provision of food and fluid at the end of life
Disclaimer: Within this section of the module, there are a number of infographics which include the now outdated term “feeding”. Out with these infographics we have updated terminology to avoid the use of “feeding”, this includes nutrition and hydration, assisting with eating and drinking and eating and drinking with acknowledged risks. The RCP (2021) report preference for “eating and drinking” over “oral feeding”, with aim of moving towards a more person-centered approach. The Royal College of Speech and Language Therapists (RCSLT, 2021) encourage the use of the term “eating and drinking with acknowledged risks” versus “risk feeding” or similar terms.
Page last reviewed: 16 Jan 2023
