A dying patient cannot drink and has distressing thirst and fluctuating delirium. Mouth care has not relieved symptoms. There is no pulmonary oedema.

Question

A dying patient cannot drink and has distressing thirst and fluctuating delirium. Mouth care has not relieved symptoms. There is no pulmonary oedema. Which plan best follows NICE?

Accepted Answer

Offer an individualised therapeutic trial of clinically assisted hydration, review at least every 12 hours and stop or reduce it if harm develops

Answer

Use mouth care alone because assisted hydration has no role once the dying phase is recognised

Answer

Continue a fixed 1 litre per day until death, using urine output as the only treatment target

Answer

Start maintenance intravenous fluid and continue unless serum sodium falls below 130 mmol/L

Answer

Give 500 mL subcutaneously over 12 hours and schedule the first clinical review at 48 hours

Care in the last days of life in dementia — SCE Geriatric Medicine MCQ

A dying patient cannot drink and has distressing thirst and fluctuating delirium. Mouth care has not relieved symptoms. There is no pulmonary oedema. Which plan best follows NICE?