ABSTRACT
Dehydration in terminally ill patients is a common condition and its treatment in an active oncology unit often involves intravenous (IV) hydration programs. The decision to use IV hydration is only partly determined by an objective assessment of the clinical data. The other component is the attitudes of those involved in the decision-making process. This pilot study surveyed the attitudes of patients, family members/friends, nurses and doctors toward IV hydration in this patient population. Although the majority of the conscious patients (95%), family members/friends (81%), and nurses (64%) were not involved in the decision-making process, the expressed attitudes were generally positive. The three most commonly stated reasons for IV therapy were "medication," "giving fluids" and "giving morphine." Interestingly, among the reasons expressed, the amelioration of thirst was never explicitly cited.
Subject(s)
Fluid Therapy , Neoplasms/therapy , Terminal Care/psychology , Attitude , Attitude of Health Personnel , Decision Making , Family , Humans , Infusions, Intravenous , Pilot ProjectsSubject(s)
Ascites/etiology , Edema/etiology , Fluid Therapy/adverse effects , Respiratory Sounds/etiology , Terminal Care , Adult , Aged , Humans , Infusions, Intravenous , Israel , Middle AgedABSTRACT
Cancer patients in the terminal phase of their disease often experience fluid deficits. This is mainly due to their inability to ingest adequate amounts of oral fluids to meet the body's physiological demands. In order to correct this deficit, intravenous (i.v.) fluid programs are often instituted. This pilot study was conducted on a group of terminal patients hospitalized in an oncology unit who died while receiving i.v. fluids. It sought to assess the effects of these fluids on their level of thirst. Data were collected on 30 patients in the last 24 hours of life. However, of the 30 patients only 19 were sufficiently alert to be able to verbally evaluate their thirst intensity. Of the 19 patients, six experienced mild thirst, eight moderate thirst, and four severe thirst. This was in spite of IAV hydration regimens which ranged from 500 mL to 3000 mL. Little relationships was found between level of thirst and the amount of i.v. fluids received, blood urea nitrogen (BUN), or sodium blood levels. In addition, although 70% of the patients had fluid retention signs, there was little correlation between these signs and the amount of fluids received. Since the pilot study's sample was small, definitive conclusions could not be drawn. However, our results highlight the need for future research in this area.