Living "weeks to months" with no food and sips of fluid? Really?

  1. 2 My father in law was placed on hospice yesterday. He has had nothing - literally - to eat for weeks. Weight loss - which he did not need in the first place - has been tremendous - he is over 6 ft and weighs less than 120 at last wt which was about 2 wks ago.

    He was getting IV therapy and taking ice chips/sips of water in the hospital which he was discharged from home to hospice yesterday as I said. He does not, that we know of, have cancer. There is a "bleed" somewhere inside they cannot find and he is not willing/able to go through surgery to find it.

    He was given a blood transfusion about 5 days ago before the decision to place him on hospice was made. He is in his 80's and basically, his body has just had enough. He is alert and oriented. IV fluids were stopped yesterday before he was sent home. He has had sips of gatorade and ice chips since then. The hospice nurse who came out to do the admission told him/the family that he could live "weeks or months" just on the sips of gatorade/water/ice chips because the body will absorb all this and "hold it."

    When I tell you sips I mean a normal size bottle of gatorade is going to last him DAYS...I have never heard of someone, especially someone who is already compromised, lasting months on sips of fluid and no food.

    He does have a catheter - it was placed in the hospital and the decision was made to leave it since he is so weak and has fallen in the hospital. His urine is fairly dark and the output not all that great, because he has not eaten in wks he has not had a BM in about a month.

    According to the hospital staff/his doctor, nothing has come out - not even the blood - he has about 3 L of fluid sitting in his stomach. He is on oxygen and that is another thing she said - was the oxygen would keep him breathing "longer than normal." She is young, seems fairly inexperienced and though nice I politely asked her, in private of course, about the stuff she said re: oxygen/fluids.

    She said "new research has shown what I said to be true." I left it at that but would really like the opinions/thoughts of other hospice nurses on here as I do not want my father in law or his family to be under misguided assumptions on how this is going to go over the next wk and I think they are thinking he has a lot more time left than he really does.
    Last edit by Blanca R on Jun 24, '12 : Reason: spacing
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  3. Visit  Marshall1 profile page

    About Marshall1

    Joined Nov '09; Posts: 870; Likes: 669.

    23 Comments so far...

  4. Visit  Esme12 profile page
    2
    what are you asking, exactly. without out knowing the intimate details of your grandfathers case it is impossible to know what to say or how to advise you. we cannot offer medical advice as per the terms of service.......
    you agree not to seek medical or legal advice.
    you agree not to offer medical or legal advice.

    allnurses.com, inc or it's members do not offer medical advice. any requests for such will be taken down. if you have a medical problem, please seek attention from your health care provider. you are not allowed to ask for medical advice related to a health situation that affects you, a family member, or someone you know.
    i noticed that you have worked hospice on occasion with a prn basis...maybe you could advise your family. as an experienced nurse you know there is no real set time table for a patients deterioration or death. with 3 liters of fluid in the abdomen it sounds like there is something occult going on the you are unaware of....the presence or absence of the o2 will not postpone nor hasten your fil's demise, but can be viewed as a comfort care measure to ease their distress.

    my experience with family personally has been they will hear what they wish to hear and accept what they want. nothing more, nothing less. i will always give accurate medical information and leave it on the table so i don't hear "why didn't you tell us" later. i did however put my foot down firmly when my grandmother, at age 93 (after ovarian cancer, uterine cancer, a stroke, a fracture hip, pna etc) had an odontoid fracture that was unstable and my aunt wanted her to have surgery. so we did bring her home.

    i would address the nurses misinformation with the hospice provider. i don't think sips of "gatorade"tm will over all assist/prevent any progression of his condition but if it comforts him. the decision for fluids or no fluids are best handled by the provider and the family, hcp, or poa.

    i am sorry your family is going through this and my prayers for you and your family.
    tewdles and TopazLover like this.
  5. Visit  MN-Nurse profile page
    0
    Quote from Marshall1
    I have never heard of someone, especially someone who is already compromised, lasting months on sips of fluid and no food.
    Me either.
  6. Visit  Marshall1 profile page
    0
    Thanks for the replies..I realize my posting wasn't clear..I wanted to know if anyone out there had heard of the "new research" this hospice nurse was referencing - I see where my post is confusing - I apologize -
  7. Visit  Esme12 profile page
    4
    Not that I've heard. I discuss this with the agency or her supervisor. I tell people that my crystal ball is cloudy or that god doesn't have a time clock. I've sssen folks with IV O2, A&) pass on the way top the elevator and No IV/O2 or PO linger forever......God has his own time clock.
    enchantmentdis, tewdles, SNB1014, and 1 other like this.
  8. Visit  CapeCodMermaid profile page
    2
    I don't think it would be considered giving medical advice to say HUH??? Oxygen will keep him breathing longer?? Not true. I have seen many patients linger for weeks on no food or fluid intake. As Esme12 said, God has his own time clock.I hope you and your family find peace.
    Vtachy1 and tewdles like this.
  9. Visit  mercurysmom profile page
    2
    I did a little digging and found a ppt (in pdf form) from a Hospice in Australia that gives a handful of case histories of pt's who lived much longer than expected with little to no fluid intake. I wish I could find a transcript or youtube video of the actual presentation since it looked interesting, but no luck. http://www.palliativecare.org.au/Portals/46/Together conference/D5 Doug Bridge.pdf

    Here's a 2011 podcast discussing the physiological benefits of "terminal dehydration"vs the psychosocial reactions and perceptions of families and caregivers. (This site has some really great topics, and each entry includes a full transcript along with the podcast recording, even some recordings of interviews and resource lists. What a treat! ) http://healthpodcasts.blogspot.com/2011/06/terminal-dehydration-experience-and.html

    mm


    tewdles and Esme12 like this.
  10. Visit  KelRN215 profile page
    1
    I have known patients to live 2-3 weeks with no intake but not months.
    tewdles likes this.
  11. Visit  RNGriffin profile page
    0
    I wouldn't call the nurse inexperienced, as there have been several cases I have attended where the individual has sustained, although comatose was present, with no nutritional intake. The body has a way of metabolizing fat reserves( i.e. glycogen, adipose, etc.) in order to obtain nutrition.
    I would definitely raise an eyebrow to the statement that oxygen will likely delay your father in law's demise. If anything, if he is hemorrhaging in a unspecific location it's impossible to determine his life expectancy. Oxygen will have little effect if the BP is below the normal range, what's going to transport this oxygen? But, we all know the brain and heart are the first to receive the limited supply we may carry. I would urge you to encourage your father in law, if it means that much, to opt for a G-tube. Life expectancy is very bleak at this moment.
  12. Visit  CapeCodMermaid profile page
    2
    Why would you suggest a gtube? What about quality of life?
    Sugar Magnolia and ohioSICUrn like this.
  13. Visit  caroladybelle profile page
    1
    I have seen people last over 6 weeks with little PO intake.

    As far as O2, it is a comfort measure more than anything, thus I rarely worry whether it will lengthen life or not, as long as it is not causing discomfort.

    G-d/mother nature/ our creator has their own timetable for death, and I do not have access to that info. Thus I do not worry about how long and exact time schedules, as life will make a fool out of us. As long as the pt is comfortable and surrounded by he loves, there is little use in trying to predict the unpredictable.
    buffieriley likes this.
  14. Visit  RNGriffin profile page
    0
    Quote from CapeCodMermaid
    Why would you suggest a gtube? What about quality of life?
    After aging the definition of "quality of life" alters.
    Last edit by RNGriffin on Jun 24, '12
  15. Visit  TopazLover profile page
    3
    I would be fearful of a G-tube. he has an occult bleed that is not being traumatically influenced by the small amount of po fluids. I would hesitate to put fluids directly into the stomach, even at a slow rate. But that is just me. Not even close to medical info. Just personal hunch.

    I would encourage family to gather and share time with him and each other. Actually what ever the timeline it will never be long enough for family members.

    God's Peace for the whole family.
    Laura Z. Pam, Vtachy1, and tewdles like this.


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