Medicine

Patient information for Translation

Fluids and the use of artificial hydration in advanced illness

Information for patients, carers, and families

This leaflet will aim to answer some frequently asked questions about fluids in advanced illness.  It is aimed mainly at carers but some patients may also find it helpful.

Normally, fluids are taken by mouth.  Artificial hydration is a medical treatment that allows a patient to receive fluids by drip when they are no longer able to take them by mouth.

1.  If someone doesn’t drink, will they die of dehydration? 

It is normal for people who are dying from advanced cancer or other illnesses eventually to stop drinking and to stop feeling thirsty.  As the body weakens and its systems work less well, there is less and less need for fluid.

If someone is very weak and is given fluid by mouth, it may go down the ‘wrong way’ and make them cough and splutter.

It is important to remember that it is the illness, which is making the body systems fail, not a lack of fluid. 

Giving fluids by mouth or drip will not restore the patient back to a healthy state.

2. What can I do if they complain that they have a dry mouth?

A dry mouth can be a common problem at any stage of an illness.  Please speak to the doctors or nurses about it.  This feeling is quite different from feeling thirsty.  Medicines such as special saliva sprays and gels are available and even boiled sweets and chewing gum can help.

1. What can I do to help?

If staff feel it is safe to do so, you can carry on offering drinks, as they will also do when you are not there, but don’t be surprised if your loved one only wants a few sips at a time.  The staff will help you to make sure that drinks are not causing coughing and spluttering.

Some patients like to have their favourite drink frozen as an ice lolly or ice chips, this can be easier to take than a drink.

2. How do you provide mouth care?

When someone is dying and too weak or sleepy to be able to take drinks in any form by mouth, nursing staff will provide regular mouth care to soothe and moisten the mouth.   This is done using small sponges dipped in water or a favourite drink.  The sponges can also be used to put oil on the lips to stop them drying and cracking. 

You are most welcome to be involved in providing this care and staff will show you how to do this if you wish.

3. Do you ever use drips?

Yes.  A drip is the name for fluid, which is usually sterile salt water, given to the patient through a tube that goes in either under the skin or into a vein.  Sometimes the doctors and nurses may feel that a drip might help particularly if there is a suggestion that the patient is thirsty.  If a drip is started, it will be regularly reviewed to see if it is helping and to make sure there are no side effects from it.

However, for most people with only hours or days to live, their body systems are shutting down and thirst is not a problem.  Drips often do not help and good mouth care to moisten the mouth and lips is the most helpful comfort measure.

1. Are there any disadvantages to having a drip?

Yes.  In the last few hours or days of life, the body cannot handle fluid as efficiently as before.  Giving fluid by drip can sometimes make things worse by overloading the delicate fluid balance mechanisms of the body at this time.  If this happens, the person may experience ‘chestiness’ or noisy breathing or swelling of the arms or legs as their body cannot process the fluid from the drip and it ends up in the wrong place.

2. Once a decision about a drip has been made, is it final?

No.  The doctors and nurses will always monitor the situation and discuss it on a regular basis. 

If the patient is too ill to take part in the decision making, the doctors and nurses will make a careful assessment and have a discussion with the patient’s family about the right thing to do.

The ultimate responsibility for decisions about starting and stopping a drip rests with the senior doctor caring for the patient.  A decision that has been made can always be reviewed.

Large print and other languages
This information can be made available in alternative formats, such as easy read or large print, and may be available in alternative languages, upon request. For more information, speak to your clinical team.
 

এই তথ্যগুলো সহজে পড়া যায় অথবা বৃহৎ প্রিন্টের মত বিকল্প ফরম্যাটে পাওয়া যাবে, এবং অনুরোধে অন্য ভাষায়ও পাওয়া যেতে পারে। আরো তথ্যের জন্য আপনার ক্লিনিক্যাল টিমের সাথে কথা বলুন।

Na żądanie te informacje mogą zostać udostępnione w innych formatach, takich jak zapis większą czcionką lub łatwą do czytania, a także w innych językach. Aby uzyskać więcej informacji, porozmawiaj ze swoim zespołem specjalistów.

Macluumaadkaan waxaa loo heli karaa qaab kale, sida ugu akhrinta ugu fudud, ama far waa weyn, waxana laga yabaa in lagu heli luuqaado Kale, haddii la codsado. Wixii macluumaad dheeraad ah, kala hadal kooxda xarunta caafimaadka.

Bu bilgi, kolay okunurluk veya büyük baskılar gibi alternatif biçimlerde sunulabilir, ve talep üzerine Alternatif Dillerde sunulabilir. Daha fazla bilgi için klinik ekibinizle irtibata geçin.

یہ معلومات متبادل فارمیٹس میں دستیاب کی جا سکتی ہیں، جیسا کہ پڑھنے میں آسان یا بڑا پرنٹ  اور درخواست پر متبادل زبانوں میں بھی دستیاب ہو سکتی ہیں۔ مزید معلومات کے لیے، اپنی کلینکل ٹیم سے بات کریں'۔

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Reference: BH/PIN/909

Publication date: November 2022

All our patient information leaflets are reviewed every three years.

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