A Publication on the (Voluntary) Renouncement of Food and Liquids at the End of Life
The Academy at Johannes-Hospiz together with two colleagues from the in-patient hospice and the directing physician of the specialized out-patient palliative services in Münster published a contribution in the November 2016 edition of the Journal for Palliative Medicine, where they expressed reflections and offers from a hospice point of view concerning the care for residents who (voluntarily) renounced food.
To care for people renouncing food with foresight and, well aware of possible negative side effects, in an attentive, transparent and well-designed medical way should by no means be taken for granted.
It was just this insight the authors had to concede themselves after several demanding attendances. Many things went little satisfactory. They often reacted instead of acting with foresight. The offers and measures seemed to be singular, too emotional for meeting the claim of professional support. The contribution gives an insight into a process of development, a pathway of learning so to speak at the end of which are the instruments which are being explained in the insertion of the journal or can be downloaded as a questionnaire on the Academy’s homepage.
With these instruments, an attendance with foresight will be easier, and important conversations between all persons involved and among colleagues will have an orienting basis. This guide for action aims at a cautious reduction of food and liquids, intends to prevent expected negative side effects or at least reduce them to an acceptable level and provide a transparent and complete documentation. Not least, the publication is a response from practical work to meet the patient’s will. This is also relevant for in-patient geriatric care, where we find increasingly situations like long time PEG probes straining the patient while at the same time his will is more clearly articulated. And in the ethical and legal discussion, these instruments form a voice which allows for nursing and medical aspects of palliative attendance after the decision. Care will be formulated as an offer which should be carefully reflected and which needs an exact examination of these very ethical, legal, nursing and medical aspects.