Question

A 78 year old woman with advanced metastatic lung cancer is admitted with worsening breathlessness and is bedbound. The multidisciplinary team agree she is likely in the last days of life. She is drowsy but comfortable on small doses of subcutaneous Morphine for breathlessness. Her daughter asks whether clinically assisted hydration should be started with intravenous fluids to prevent dehydration. According to NICE end of life care guidance, what is the most appropriate response?

Accepted Answer

Discuss the potential benefits and burdens of clinically assisted hydration and consider a trial if there is uncertainty about its benefit

Answer

Start high volume intravenous fluids to correct dehydration in all dying patients

Answer

Explain that clinically assisted hydration should never be used at the end of life

Answer

Refuse hydration and discharge decisions solely to the daughter

Answer

Arrange total parenteral nutrition instead of hydration

Practice question