Question

An 82-year-old woman with advanced heart failure is in the last days of life. She is semi-conscious and taking minimal oral fluids. Her family ask you to start intravenous fluids to keep her going. She is comfortable with no signs of thirst. According to NICE end-of-life care guidance, what is the most appropriate response?

Accepted Answer

Explain the limited evidence for benefit, assess for signs of dehydration or distress and consider a trial of clinically assisted hydration only if there is likely to be benefit and she would have wanted it

Answer

Start intravenous fluids at 1 litre per 8 hours for all dying patients

Answer

Refuse hydration in all cases as it prolongs dying

Answer

Insert a nasogastric tube for feeding

Answer

Transfer her to intensive care for aggressive fluid resuscitation

Practice question