Managing the nutritional needs of palliative care patients
Abstract
The nutritional needs of patients receiving palliative care should be routinely assessed, taking into account disease trajectory and nutrition-related symptoms. The social and emotional aspects of eating and drinking should also be acknowledged; as should the distress that weight loss and anorexia engenders in patients and their families. Practical strategies to optimise nutritional intake are discussed. Open and sensitive communication of patients’ needs and wishes is essential, especially when discussing complementary nutrition approaches. A holistic, multidisciplinary approach is key to meeting nutritional needs, and the goals of nutritional intervention should be regularly reviewed in the light of disease progression.
Palliative care is an approach that aims to improve the quality of life (QoL) of patients and their families facing the problems associated with life-threatening illness, through the prevention and the relief of suffering by means of early identification and assessment, and the treatment of pain and other problems, whether they be physical, psychosocial or spiritual.1
Reduced food intake and weight loss are commonly seen in patients towards the end of life and have been identified as a source of distress for patients and their families.2 It has been suggested that 20% of patients with advanced cancer may die prematurely as a result of malnutrition.3
However, nutritional needs are not routinely assessed by health professionals, largely due to a belief that nothing can be done to help people live with these symptoms.2 In response to these findings, Help the Hospices, now Hospice UK, published a consensus statement for nutritional care in palliative patients, recommending that nutritional needs should be identified and an individualised care plan implemented that takes account of the stage they are at on their disease trajectory. A holistic approach to nutritional care planning should be taken, acknowledging the social, cultural and emotional aspects of eating as well as nutritional needs. It was also recommended that all health-care staff working with palliative patients should receive nutrition education and that organisational policies should be in place to enable nutritional care to be delivered safely and effectively.4
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