Question

A 78-year-old woman with advanced pancreatic cancer is in the last days of life. She is drowsy, taking very little orally and her family are distressed that she is receiving only small amounts of subcutaneous fluids. According to NICE guidance, what is the most appropriate approach to hydration at this stage?

Accepted Answer

Offer clinically assisted hydration only if it is likely to improve symptoms and review regularly

Answer

Start aggressive intravenous fluid resuscitation to normalise blood tests

Answer

Withhold all fluids because artificial hydration is always harmful at the end of life

Answer

Insert a nasogastric tube for continuous feeding and fluids

Answer

Discharge home with no further assessment

Practice question