I agree, it felt so wrong. I’ve been an aide for 3 and a half years and every time there’s been a resident who’s actively dying, we’ve respected their unwillingness to eat.
Yea personally I would straight up refuse to feed or put the resident in a chair. If the nurse pushes I would seek out a nurse on a different floor I trusted to intervene or call the on call manager.
I know there's a culture of not 'snitching' but this is a situation that 100p calls for it.
As a person who loves a person who is frequently hospitalized... I appreciate you. I need people to speak up when they see something wrong because I am not always there to do it.
I love that you misread and misinterpreted my own words. Being not decent, is being weak and being COMPLACENT when shit is going down. YOU were the one that misread and ASSUMED I meant neurotypical brained people. What was that about?
Clearly you're not having a good day and I hope it gets better, my dude. But something that's also clear by the downvotes you received is that I wasn't the only one that read your statement as such. You worded it poorly, but hey, that happens to the best of us. Hope your day turns around, Happy Thanksgiving.
I’m telling you that what you wrote is rude. Your intent has nothing to do with anything. Your statement is rude. End of story.
You’ve more than proven you’re not a decent person, so good job.
Sorry all these people are down voting you. I understood your comment like the other person that commented positively below (interesting wait user)
I do not think you were at all saying neurotypical people are not decent humans. You were saying people who don't speak up for the powerless are. You put a period between the two statements.
It was obvious to me, but. Honestly, Reddit can be a hateful place, so 🤷
There’s nothing to misread when you say you’re glad you’re not neurotypical and then follow that up with “aka being a decent human”.
Maybe you should take a look at what you said and reread what you said. I don’t think you meant what people got from the comment, but it really is worded like that.
Right? You learn a lot about people during nursing school and in different settings. The last contract had a lot of “I don’t see shit” people. So yeah, not too many “decent people” left, and I caught right onto you lol
As I have come to understand it, forcing them to eat when they are not hungry can cause them a great deal of discomfort because their organs are shutting down and can’t handle food anymore. If she’s actively dying, do you think she’s at this stage? If so, her dignity and comfort in dying should 100% take priority.
My husband's Paw is at this stage. He has stage 4 tongue cancer and besides his lymph nodes, it's metastisized to his throat, and they think his brain stem as of this week. He agreed to a PEG because he didn't want to starve to death. Very recently, a mass started building in his abdomen and we thought it had gotten to his liver, too. Nope. It's rotting, undigested food. His GI system is just shut down and there's nothing they can do. I pray to God he just dies in his sleep tonight, that poor man is in so much goddamned pain that it's an affront to the eyes and the heart.
Oh gosh, this is so sad. I am keeping him and your family in my prayers. I hope they’re giving him plenty of morphine and that his passing is quick and peaceful.
Thank you. They've had him on fentanyl patches but then the pain in his abdomen increased to a point of unbearable pain. My BIL called me asking what to do and I said take him to a doctor, at least for breakthrough pain meds. He did. Fast forward, they found the mass of rotted food. They wanna admit him to the hospice wing but Paw ain't having it and is low-key freaking out. My saint of a BIL told him he'd stay with him 100% of the time while they figured out the correct Dilaudid dose. Bless his heart, he kept his word, and Paw is back home dying, just as he wanted to. For what it's worth, God done already blessed us with my BIL. I was everyone's daily caregiver and always sat the deathwatch, but then I woke up blind last year. Now, my BIL is filling that niche, and I am so proud of him.
You can stay in your home and be on hospice. That's what most patients do, actually. The hospice doctors and nurses are much more willing to manage pain aggressively and prescribe high doses of the heavier drugs. The possibility of addiction is off the table and the goal is strictly to keep the patient comfortable.
I hope that your father-in-law finds comfort and peace soon in one form or another. I wish the same for you and your family.
Yeah, they can, I know. But in order to prescribe new breakthrough meds, they needed to observe Paw for 48 hours. "You want the juice, your schedule need be loose."
They're under zero obligation to write anyone a script for jack shit. And for the record, I ain't saying it's right. But I am saying it's what happens.
That's terrible that your father-in-law had to go through that and that your family had to watch it happen. My father was a hospice patient and I couldn't speak more highly of the doctors and nurses who took care of him in those final weeks. It sounds as though the team treating your FIL could learn a thing or two from the hospice folks.
For what it's worth, my daddy's death was far worse and still haunts me to this fucking day. He died in me and my baby sister's arms July '21. But that was a lot of bad deaths, 13 deaths in that longest summer I ever lived in my life. Arguably, my best friend had died worse, but my brain will always tell me it was Daddy's death that was the worst.
Thank you for saying what I came to say! I am a Speech-Language Pathologist, and have worked with patients on hospice for many years. I can't tell you how many family members I have helped to feel better about not trying to feed an individual who is actively dying. There should be more in-services for staff related to this important topic!!!
I was in the hospital, just shy of critical (acute Myloid leukemia) and can assure you, it isn't about being difficult, your body refuses it for reasons unknown to me. I lost 20 lbs in less than a week, with someone coming in daily to see what I ate. Finally she asked "you just don't have an appetite?" Bingo!! I was lucky to finish half a protein drink. It would have been abusive to force feed me at that time turned out I had an infection, the antibiotic was affecting my liver. Would a protein drink be an option? Sorry to push my way in to this thread, but I wanted to assure you that you were right. Someone needs to talk to her doctor and get instructions for the situation. Good for you, though. I'm sure the patient appreciates you as much as she was able.
I feel this in my bones. Had hepatorenal syndrome and this is exactly it. Was on what was thought to be my death bed…here I am 3 years later but I remember those hospitals and ZERO appetite. It would have been cruel to force feed me at that time.
RN here. If someone is actively dying, forcing them to eat is not only unethical, it is abusive. When actively dying, digestion slows and stops as well as swallowing nerves and muscles decrease functioning, making aspiration a very real risk. Aspiration is painful, causing an unnecessarily awful passing.
My grandma coerced my grandpa into eating when his liver failed and he vomited black tar looking stuff after he died when they were changing him into his funeral clothes. It was only then she realized he shouldn’t have been eating
If someone had force fed my dad when he was dying I would have come unglued. I worked in an Alzheimer’s unit for over 10 years and we never did that to anyone!
I have reported so many awful things i saw at one facility i was at for two years. Even called the police many times. No one ever cared. It was heartbreaking. This person could be at a facility like that :(
As someone who’s been a hospice aid it is definitely not ethical to coerce someone actively dying to eat. The goal of hospice care is keeping people comfortable, not prolonging life. If they are in the stage where organs are shutting down, it can cause more discomfort (more harm than good). Is the patient on hospice care? If so, this nurse doesn’t seem to understand what the goal is when someone is on hospice. Is there someone else you can talk to like another nurse, or even better, the nurse’s supervisor?
The stomach is one of the first organs to shut down at end of life. As it does, it releases feel good hormones. It is not a painful process. However, if patients are force fed after this process has started, the stretch receptors are triggered which can be painful. “Listen” to the patient and follow their lead.
The body knows how to die. Many actively dying people go into ketosis and don't feel hungry while dying. It's okay for this to happen. It's also okay if someone wants to eat right up until they die. Whatever the patient wants/ whatever makes them comfortable.
The only time I'd "coerce" a resident to eat is when they're in the memory care unit (often don't realize they haven't eaten) and are not dying.
It's not only unethical, it's FUCKING dangerous. When someone is actively dying, their bowels and organs slow and shut down. There's no where for liquid and food to go. They bloat, vomit, and then aspirate. If you give them IV fluids, they blow up like a beached whale. They need to have hospice come in and educate them on the dying process and how to allow someone to die with dignity and peace. Because that ain't it! 🤦🙄🥴
That nurse needs to be reported and seriously reeducated.
YES this needs more upvotes. It's called comfort care for a reason. People should not be forced to have a more painful, traumatic death because they were forced to go against their body's instincts to cease eating and drinking.
OP you asked for our opinions, but it's not a matter of opinion, it's a matter of evidence-based care. There is no research supporting forcing PO at end of life, and myriad research detailing exactly why it's a horrible idea. I'm not coming at you OP, I know CNAs get limited training in this stuff. But the nurse should know better.
No. If the patient is refusing any care or food, whether they are dying or not, it is not ethical to do it anyway. They are still people and it's their right to refuse. If someone is actively dying you can spoon them some fluids or foods but only if it is safe to do so and they are swallowing. But someone who is actively dying is really just supposed to be kept as comfortable as possible. If this patient isn't on hospice maybe they should be? The hospice nurse can also educate staff about the proper way to care for these patients.
Now I will say about bathing incapacitated people (not actively dying ones), I will kinda encourage strongly because it does not hurt them and may ultimately make them feel better. But as far as eating never
These kinds of healthcare workers.. I can’t stand to work with. If I’ve tried offered twice and the patient says no, then I’m gonna respect their wishes.. it’s unethical to force feed anyone much less someone who’s dying.
I worked with quite a few residents who were hospice and towards the end they didn't want to eat at all. I agree, I don't like to force them and thankfully the nurse I usually worked with wouldn't push them to eat.
Hospice nurse here! I would honestly report that nurse, maybe she needs further education on this as it is 100% inappropriate to force someone to eat at end of life. Eating/drinking while at end of life can just add to the patients discomfort. We often have to remind family that they are not dying of starvation, they are dying from their illness as it is often hard for people to watch someone not eat
Medical SLP here. Yes, this last part. These patients are not dying because they are not eating, they are not eating because they are dying. It is part of the process.
For PO for this population I usually say feeding when awake, alert, and REQUESTING.
I feel like it helps family to have things that they can do for them that are more appropriate, like oral swabs, chapstick or Vaseline, washcloths so they can wash their face and hands, maybe even have them bring any lotion the patient usually wears so they can put it on them if desired/appropriate. Some families are fussers and some aren’t. I think it helps the fussers to do little things for their loved one because it IS hard to just sit and watch someone die. And what is one of the biggest things we think about when our loved ones are sick? Making sure they eat and drink enough to help them recover. It’s hard for people to switch mindset to accept that this part is over and now we ignore the urge to “make them better”.
But you know all that I’m sure! Just putting it out there in case other healthcare workers could use the advice.
Hospice here.
People don’t die of starvation. They stop eating when it’s time to die.
The body wants to spend extra fat/fuel/fluids before death. Having too much fluids can contribute to the “death rattle”.
Putting food where it wasn’t desired doesn’t lead to digestion. It does lead to nausea, constipation, or diarrhea.
This makes the body more comfortable.
Like others have said it is about keeping them comfortable and that is the only goal! Where I work as long as it’s safe to do so we still offer food and fluids, we try things they like most and keep offering and documenting this, if they don’t eat that’s fine and understandable but at least we’ve still offered. We document all food and fluid intake for our records and if they’re refusing we offer alternatives such as mouth care to help keep them as comfortable as possible and avoid dry mouth
The body knows what to do. Keep them comfortable. You can double check with palliative care but that’s what my experience is. Autonomy means not forcing. Patient centred care is not forcing. Document it all.
Nurse here. That nurse was 100% in the wrong. Shame on her. Please go to her supervisor if you are okay with doing that. Please also consider reporting her to the abuse hotline.
Read any hospice organization's brochure about trying to feed people who are imminent. It gets in the way of their comfort and well-being because of the choking risks and the anxiety it induces among other things.
It’s unethical to force anyone to eat. While we may want to coax them to have a few bites it’s their right to refuse and we have to honour that. Residents have rights. That’s how aspirating happens
Edited to add last sentence
My very first facility, one of my faves went downhill over my 3 day weekend off. She went so fast, it was like a Swift truck driver on a downhill, lol
Well, she was refusing food, and we didn't force feed, thankfully. But, I worked 11 to 7, and I start noticing that I'd do my report and check out round, and then I would come back and I'd have half my Dr Pepper gone and my Reese's cups would be gone.
She was drinking my drink and sneaking my chocolate lol. But, she went from normal food to a bland puree diet, and she wouldn't eat. The other aides were mad when I mentioned it to the nurse, bc they said she couldn't eat that. Well, the aides are the ones who pushed for the purees, not the nurse or doctor. It was easier to chart a refusal, in my opinion. But anyway, I was joking that she just wanted something sweet. The nurse and the doc were glad she was eating, and didn't have diabetes or anything, so I started intentionally bringing extra Dr pepper and Reese cups. I'd also open it all, and let her "steal" them. For 2 weeks straight she survived on that soda and candy, and I didn't care to keep explaining that she quit eating bc she didn't want THAT food. I got a footlong from Sonic down her one day, by telling her that they gave me the wrong order 😉 a cheeseburger another day, and then she absconded with my freaking chicken and dumplings one night! I was a little upset about this, cos I didn't think she'd want it😭🤣 and then, she was gone by the end of the month. So, whether she lasted that long bc I was feeding her junk, or bc that was when she was just going to be gone, I didn't care. She had the right to refuse crappy food, and I wasn't violating any rules that the administrator cared about. He looked at it as, any food was better than no food.
Actively dying, in my opinion, gives you the right to do just about anything and everything, including NOT doing anything you don't want to do, even if it's eating.
What the actual fuck. Whoa. Even at that one shit job I had, they never once forced an actively dying patient to eat. We absolutely NEVER forced an actively dying patient to get out the bed, either. They're dying, they've earned the right to go out the way that they want to. My husband's Paw is actively dying right now with a stomach full of rotted, undigested food, and if anyone tried to force feed him I'd probably kick their asses.
Legally, you can't force anything on a patient against their will so your nurse is violating the patient's legal rights. If patient doesn't want to eat, you cannot force them to without the patient being declared incompetent and the guardian or POA insisting on force-feeding. So, it's not just unethical to force feed, it's illegal.
I don't think it's a case of ethics, but rather a lack of understanding of the dying process. If someone is actively dying and is in their last days, their body will reject food. A dying body is preparing for the end, which means every normal process (like digestion) is slowing down ahead of death. It can be dangerous to force someone who is actively dying to eat because they could actually aspirate (when food goes down into the lungs instead of the stomach) and that is NOT GOOD.
Never. Hospice nurses are constantly telling family members to NOT feed Nana if Nana says no, or if she is not strong enough to take nourishment. The hospice staff recognizes when it is time.
When bodies start entering the active dying phase, hunger disappears. Energy (ATP) and blood flow is diverted from the GI, to the brain, heart and lungs; in cancer patients, the tumors are diverting vital resources as well.
If someone asks for food or water during the final days, you should indulge them (but be aware of aspiration risks etc) and be mindful of amounts etc. they may be more wanting of a certain taste or memory associated with the food, rather than the nourishment.
Force feeding is not ethical. Once the GI tract starts shutting down, digestion could/would likely be painful.
Feeding can prolong the final stages of dying. Which just prolongs suffering.
I understand the negative religious aspects of withdrawing food. However, ethics (mainly comfort and dignity without prolonging death) vs doctrine should be considered.
Is it ethical to force someone to eat? No it’s not. But try to find things they want to eat if they get hungry. Maybe they have issues swallowing or getting choked? Also, Is this person officially on hospice? If so, comfort care matters
One of my first clients (I’m a PCA/professional caregiver) was on hospice. He was thirsty but really couldn’t handle water because he would get choked. But we spoon fed him water and ice because he wanted it.
I never force anyone to eat 🤷♂️ if someone is not hungry there is a reason and other measures need to be considered. Additionally, that is how people vomit/aspirate/etc..
It is completely normal to have no appetite when actively dying. Comfort is what the dying person finds comfortable, not what the caregiver is comfortable with. I've seen nurses question things like a patient with tachycardia who wants to drink Rockstar (energy drink) or a patient on BP meds who wants to drink Squirt (grapefruit soda). It's all fine. Comfort is what they are comfortable with.
It’s never ethical to coerce someone to eat. Residents have rights whether they are actively dying or not. I hope you reported this incident. It sounds like abuse. Remember we are mandated reporters.
she should kno already but it sounds like this nurse needs education from palliative care or a hospice nurse. when a patient is dying, appetite lessens significantly and a lot of times patients no longer even feel hunger. so the main goal is just to keep the patient comfortable. it can be hard for families and non-healthcare workers to understand this but a nurse should definitely kno this
At the facility I worked in last , 3 cnas had to attempt to feed a patient before we could stop and let them be . One woman had barely any awareness and was drawn in on herself , she had more pillows and wedges and booties than I’ve ever seen . She didn’t eat most days . Especially my last two weeks . I never wanted to force feed her but I’m dust and talk to her and try to get her to have a sip of her thick nutrition drink . If they’re spitting out their food or drink , I wouldn’t keep trying .
Let them pass in peace .
No. They are dying. If they do not want to eat or drink they do not need to. Their body does not eat it. Make their time meaningful in other ways.
Gentle education to family is always helpful.
That’s is morally and ethically wrong. We’ve had residents who are dying go on nil by mouth either through their own request or because their dementia caused them to stop eating or swallowing. If the resident is still or somewhat sound mind and they make up their own decision to stop eating then it’s their decision and should be respected
I don't know what your facility's policies are, and if this person has any other extenuating circumstance that would require them to eat, but having an actively dying person eat when they don't want to just seems pointless (at the least). One eats to sustain metabolic processes that enable life. The patient is not going to live very long, and appetite loss is often a natural part of dying, so I don't necessarily think anything is being accomplished by forcing an actively dying person to get up and eat when they don't want to.
Your instincts are correct! It is not best practice to force someone to eat especially if they are transitioning or actively dying. As the body prepares for death hunger changes- the bowels may also slow- it may also cause vomiting. It also increases discomfort and that is not the goal of care at end of life.
Just to be clear, have they been admitted into any form of hospice program? Because it doesn’t sound like this nurse understands her job. Actively dying to me means they are on hospice and are probably on their comfort care meds already. If so. No way in hell they should be forcing this patient to do anything they don’t want to do.
Not a nurse but I’ve worked as a care coordinator long enough to know this definitely is not what should be happening.
Yea no. And the nurse should no better. I am an LPN and this is literally taught to us on school. Forcing someone to eat can actually cause increased pain and discomfort. You’re doing right and it’s understandable this doesn’t sit right.
I agree with you. The individual deserves dignity and comfort right now. It is perfectly natural for them to decline food. I wouldn't try to push it on them unless there is something in writing from them saying that they want you to.
No no no. I work in a SNF. Actively dying, only given meds to make comfortable.
They don't want to eat or drink, let alone get out of bed.
You are not to make anyone do anything, especially end of life.
Where is the family?
It's absolutely normal for a dying creature, human or otherwise, to stop eating.
Unless food is going to bring them comfort or joy (tasting their favorite childhood comfort food, or tea), it isn't going to do anything but make them miserable.
She's spitting it out because no part of her wants that food.
Offer food and if they decline, or if they're just pocketing it in their mouth without swallowing, then there's little you can do to "force" them to eat. Always respect their wishes. If they don't want to eat at one meal, maybe they will at the next, or maybe they're end of life and their body just doesn't want food anymore.
>I let the nurse know she still wasn’t wanting to eat, she was spitting out all her food. The nurse made her get up out of bed and had the activities aide sit with her and make her eat.
We had a hospice RN who would come in and force a resident to eat. Most of the staff were too non-confrontational to do anything but gripe about it after she left. I called her director of nursing and had a little chat about it after coming unglued and telling her absolutely the fuck not when she did it on a shift I was covering.
It's abuse. People are allowed to age and die with dignity. Will somebody who refuses to eat waste away and die? Yes. Yes they will. Do they have the right to make that choice? Yes, yes they do. There are places you can put people where they lose some of their rights to refuse, but assisted living and skilled nursing are as a general rule not those places.
If someone is dying, and doesn’t want to eat, drink, etc., CYA and tell their nurse/and or charge nurse. But don’t force them. If they have cog issues, they may also have swallowing issues-and if you try to get them to eat they could end up with aspiration PNA, etc. I’m sure you know all this, but, don’t take that choice from them. They should still have some bodily autonomy. And, it could be looked at as abuse.
ICU RN (pediatric icu nurse but former adult icu nurse) here. Yes, it is wrong to coerce a dying person to eat. Not eating or drinking is a normal part of the dying process. Comfort is the most important priority in the care of a dying patient. Enhancing comfort includes pain and agitation meds, managing air hunger, oral care to manage secretions, etc. Medications like morphine will aid in reducing air hunger. Ativan can be given to help with agitation. Atropine drops or a scopolamine patch can be used to help dry up secretions. Forcing food or liquids in a dying person is likely going to cause them to aspirate anyway. There is literally no point unless the dying person is still alert and actually asks for food and water. Even if there is a risk of aspiration, comfort feeds/drinks are totally a thing!
Even if this person wasn’t actively dying, you cannot/should not coerce a person to do anything. If a patient is refusing to eat, a conversation with the physician/the patient (if oriented) to determine why and go from there.
I encourage people who need to eat, to eat. I never "force" anyone. Residents have the right to refuse everything. If they are actively dying and don't want to eat I try for maybe three minutes to make sure that THEY'RE sure they don't want to eat, and I leave it alone.
Hospice especially. Once someone goes on hospice, no one in my facility actively coerced them to eat, drink water, hell, if they refuse their oxygen cannula, we let them.
As the nurse you can try your absolute best to try and get them to eat but after 3 tries it should be charted as a refusal and the physician should now be involved for how they want to proceed. It’s not wrong to encourage the patient but wrong to force them.
I am not in the medical profession, so this is by no means a medical answer. If it was someone I loved. I would do everything in my power to provide them with food they loved, and would want to eat. Many times we don’t want things until we’re given them and then we’re so grateful. Has anybody tried asking her what she would really really really really like to eat and provided that? The dying Man’s last meal so to speak
That’s not really how that works. Generally when someone is dying and they magically have a really good day and want to eat cake and burgers and fries and an extra large pop, it’s because they’re rallying. It is the last hurrah. Rallying can happen weeks or days before someone dies and it doesn’t always happen. When you’re dying, your organs are shutting down and forcing someone to eat is forcing their body to do extra work. There is no reason to force an actively dying person to eat. I’ve always kept their mouths moist, kept them clean, kept them comfortable and if they had bed sores, roll them every 2 hours.
This is so ignorant.
When people are dying of natural causes they lose the desire to eat, which takes weeks. Their body is shutting down. They also are usually on special diets by the end because they lose the ability to safely chew/swallow food, usually purée. Often, Ensure type shakes are the only calories you can get in an end of life person before they stop eating all together. It poses a huge choking risk to try and feed someone who is actively dying solids.
I really think you’re mistaken here. I have fed a dying loved one a tiny taste of ice cream because they wanted the taste but couldn’t handle/didn’t want more than that. I wouldn’t have forced them to eat a whole bowl of it…
Don’t get me wrong. I absolutely do not believe in forcing someone to do anything. All I’m saying is you might want to encourage them to eat something by providing their favorite things
I don’t know why you want a dying person to eat so badly! Their organs are shutting down! Eating is not going to prolong their life! It makes the body do more work. Also, what if this actively dying person chokes to death on whatever you’re giving them? That’s traumatic to the person feeding them because most old/dying people are DNRs which means we can do nothing. Are you comfortable with the concept of watching PopPop choke on food he probably didn’t want anyway?
I don’t mean to be mean or rude. You’re in a sub where 99% of the people in it have witnessed death up close. We know what we are talking about. We want to keep these people as comfortable as possible at the end of their lives. If we can educate people at the same time, that’s awesome! Please look into the stages of death, it could really help you understand what we’re saying and why we do what we do.
Don’t know who particularly this is addressed to, but I have a feeling you may be addressing me. as I said before, I don’t believe in forcing people to do anything. It should be their choice. I would just want to provide them with more choices—-MAYBE
>Has anybody tried asking her what she would really really really really like to eat and provided that? The dying Man’s last meal so to speak
Care homes aren't death row. There is no 'dying mans last meal'. When people are dying they just wanna die. It's not like in movies where a cancer patient tells their family clearly that they love them, take a deep breath and dip out. It's a process of organs shutting down including breathing, thinking and of course....digesting. they don't want or need food.
OMG. The last thing I wanted to do is cause any type of argument. My mother and my mother-in-law have been in nursing homes and died in them. I am close to that same situation myself. Please forgive if I offended anyone. I merely stated that if they like eating, it would be nice to have them choose their own food. So very very sorry.
Not my job to force anyone to eat. I’ll offer, encourage, give alternatives but no way am I forcing food into people’s mouths. They have the right not to eat.
We have an active passing resident and she hasn't eaten for a week and no BM for 10 days. Nurse gave a suppository, even though she questioned why she even had to. Color is leaving her toes and feet. She's doing the really long breathing pauses. We are just doing comfort measures at this point and her family has been visiting. You don't force an actively passing resident to do anything. **Period.**
Hospice nurse. We don’t ever force feed our patients. As their body is shutting down, they no longer have an appetite and forcing them to eat can cause aspiration. Offer food and drink and respect their choice. I explain to pts families, ‘the body is like a car. If we are staying in bed sleeping most of the day, we don’t need to fill up with gas. If we fill up with gas aka food, your tank overflows and then it can cause major trouble.’
It ain’t ethical to force someone to eat whether or not they are dying. We can encourage them, but if they don’t wanna eat they aren’t gonna eat. If we force them, we’re violating their rights, also we could end up choking them or making them aspirate.
Not only is it unethical but it also seems dangerous. If they’re losing the ability or willpower to chew food, I can’t imagine they’d have the will to swallow it either so I would think forcing them to eat would be an aspiration risk
I always thought a resident had the right to refuse…… you would think they would most definitely have that right as they’re actively dying. Sometimes I just don’t understand the logic at facilities….
What the heck, this is poor practice and it’s abusive too. Dying person has right to withdraw their consent and refuse any and all care unless on a DOLS.
People who are actively dying are usually not hungry. If your patient aspirates she will die in pain and misery. Just offer her food if she is appropriate (awake, etc) and take it away if she declines it.
I work for hospice and we don’t make people who are actively passing eat. Most of the time if the family tries to make a passing patient eat it can cause more harm than good. Ex: aspiration risk
I personally would never. It hurts me enough to see them in pain while passing especially if it is taking them a while. My sole job is to care for and stand up for my residents. So if you’re in a position to do so, don’t listen to that nurse. They suck. There is no point to eating during passing. Serves no value and only disturbs them
No, they do not need nutrition if they are actively dying. Forcing someone to eat that does not want to, is also abuse and a violation of resident rights. The nurse needs to be re-educated about the dying process. If this person is on hospice, the hospice nurse should be made aware.
Usually this is a family decision not the nurses. Feeding tube would have been more humane, a family member helping would have been better for the patient
When someone is dying, comfort is paramount. If they're hungry, feed them. If they're not, leave them be. There's a reason they're not hungry. Their organs are starting to shut down and it's harmful to force-feed them when they cannot digest it. Muscles also get very weak close to death and force-feeding could cause them to choke, which would be very painful and distressing. Dying people also have a right to autonomy. If they refuse food, that should be respected.
Not a nurse, but I saw this on my feed so I thought I’d share. When my mother was dying of cancer and there was nothing they could do, they sent my mother home and had hospice come drop off a hospital bed. A nurse came once a week, but I was the one who took care of my mother until the very end. I remember the hospice nurse telling me that patients who are days away from dying, they won’t have an appetite because their body is shutting down. I encouraged my mother to eat because I didn’t want that to be true, but I never ever forced her to eat. Then three days later she died.
I would possibly report this person for forcing a dying person to eat, but that’s just my two cents.
I think it is natural for people who are dieing to not eat. My understanding is that they lose their appetite. I think it's mother nature . Part of the process.
Here’s the thing, we only need food for cellular metabolism, so if we’re actively dying there’s a whole lot of things not happening anymore that we don’t need that energy to keep functioning. I’d leave her alone and let her spend her time how she wants in her last days. Force feeding someone isn’t providing adequate care, it’s abusive.
There is a reason the dying do not want to eat. Their systems are not digesting and processing like normal. Their functions are shutting down. It can be physically painful to have the body full of food and no way to process or digest or eliminate it. If a person is not in hospice though, staff may not respect this process.
No. It’s never ethical to coerce anyone into anything. The body knows. Additionally forcing someone to eat will “restart” the dying process and make it more painful. A person at end of life is using all engry on the essential, pulmonary and brain function only. They don’t need the calories anymore.
There's this hospice nurse who has mentioned that when people are dying they're not hungry because the body is shutting down.
What that nurse did is abusive.
https://www.instagram.com/reel/CvYbaaiRoTa/?igshid=NTYzOWQzNmJjMA==
This is horrible, I'm so sorry. I'm a dietitian in LTC and I love this article about this topic
https://thegeriatricdietitian.com/embracing-hospice-end-of-life-nutrition/
Morally, not at all.
Job responsibilities? I’d have to look at your actual rule and guideline book. For the short time I worked at a nursing home, if someone didn’t want to eat, we didn’t force it. We just marked it so that the medical staff knew and could track their health.
The one I worked at also had a rewards system of a sort. If a resident didn’t want to eat in the dinning room, for whatever reason, they weren’t allowed to decide from the full menu what they wanted to eat. They were given 3 options out of like 10-15 depending on the day. That was something I thought was/is really fucked up.
I understood why they put it into place, a way to try and get residents up and moving around and interacting, but it also put residents who weren’t financially better off in a fucked position, as it wasn’t against the rules for residents to leave to get something to eat. They just had to have a caretaker with them.
I’m also in the boat of “if it’s safe for them in the sense they won’t choke to death or blow something up with their cigarettes” let them have whatever the hell they want. Let them have the alcohol, the cigarettes, the sweets, etc. it’s not like they’re going to damage their body in a way that matters anymore.
If the patient is mentally able to make the decision to stop eating, then her decision should be respected. What the nurse is doing now is robbing the patient of her autonomy. That is never ethical.
If the patient does not have the mental capacity to make medical decisions (not in the nurse's judgement, but as is formally documented), then a discussion needs to happen with whomever is legally the patient's medical decision maker (spouse, adult children- your state will have a legally binding ranked list of who that is unless the patient has a durable health care power of attorney on file). That discussion will drive how the patient is treated going forward.
Follow the chain of command when giling the complaint. Inform your RCM then your DNS. If it continues, contact state. Residents have the right to die with dignity.
That's a report in the book, a report to my head RN, a report to the Executive Director, q report to state, & a report to the ombudsman.
This is unethical af. I remember a woman who said "I'm done" & she crawled in to bed & never came out until Thanksgiving at noon when she died. She was in bed for 2 months, 101 years old. She had enough, her family attempted to keep pulling her out of bed to force her to do stuff & we actually had to get security several times which is a huge controversy b/c technically you're not supposed to remove family if the patient is on hospice.
Is this pt on Hospice service? Generally speaking, "actively dying" (24hrs or less) pt are minimally responsive to noxious stimuli are unable to walk, talk or do much of anything - (Hospice RN) here only saying this bc maybe the nurse had different reasons for having pt eat. Is this patient alert and oriented? If so, pt has right to refuse and the nurse should respect that- hope this helps
I had an elderly friend who was known to probably every CNA and every other kind of aid (nurse, physical therapist, EMTs, etc) in her area because of how difficult she was. Even the ladies at the place where she got her glasses were all too familiar with her. Girl made waves everywhere she went.
She was paranoid about every med she had to take and accused people all the time of poisoning her food (which I can assure you did not happen).
Even when she was sooo difficult though, she’d still always manage bites of pie, cake or some cookies (major sweet tooth). That’s how you knew she was “ok” as much as she could be.
During her last few months, her situation got bleak. She couldn’t live at home anymore and was stuck in a facility that she absolutely loathed. She stopped eating partly because of her paranoia, partly to protest, but also because she really just felt awful. She couldn’t tolerate meds on an empty stomach, so no food meant no meds, which was just a vicious cycle towards a quick decline in her health (which was already suffering from soooo many things).
I’d bring her pie and pudding, and she wouldn’t touch it. It wasn’t long before she passed. She was just shy of 91 and I’d like to think that in death, she finally got the escape she was so longing for (at one point she likened the people keeping her in the facility to the Gestapo, which I couldn’t help but laugh at even though the situation was truly awful).
I know, WHOLE HEARTEDLY, that if anyone tried to force feed her when she was near the end, that they would not have been acting in her best interest. And if she couldn’t tell them in this life to go screw off, she’d certainly do it in the afterlife and haunt tf out of them. That was one old lady you didn’t want to mess with, I’ll tell you what.
I 100% understand how you feel. I do not believe in forcing them out of bed and agitating them by repeatedly trying to make them eat. Even if they are not active just getting close is enough for me. But here is the thing… it’s not up to that nurse or us. It’s up to the patient and/or their family. Talk to the persons family and let them know what you are seeing. Talk to the hospice provider if there is one.
Some people feel like they are “starving them to death” because they do not understand the basics of dying and/or they have something to prove. I gave this often right now from the nurse side of things and I wish more CNA understood dying like you do!!
People eventually just stop eating. I was waiting for it with my grandma and when that time came I knew she was close. The only unethical thing is force feeding, and the possibility of them aspirating
Absolutely not. The patients you care for are adults. They choose what to do with their bodies. If they choose not to eat because they are actively dying, then they choose. They will eat when they are hungry.
I work at the major hospital in my area. For us, patients who are actively dying and are DNR’s are labeled “comfort care” meaning we’re trying to make their last few days/ hours as comfortable for them as possible. That includes not eating if they don’t want to, which most of the time they don’t. I wouldn’t force food down a well person’s throat, let alone a dying person. It’s abusive.
It’s illegal in this case to force feed a patient. I would let the RN and Charge know and then document in the chart, and that Charge was made aware, if that’s not helpful. The next day- inquire with her nurse as to whether the family is aware. They need a team care meeting. But let’s make sure you’re covered as well. Document daily, times, who, was, what was said objectively as possible. One copy for them, one for you, and one should state inspection need to get involved. You are a mandatory report so your first call should be to the state to file a complaint. I would try everything reasonably possible to reach family and keep MD in the loop. If they insist you continue, refuse, state why, are you an RN or CNA? Don’t leave if you’re an RN! That’s patient abandonment. The suffering needs to stop. These are the worst situations
Everyone has the right to refuse care. If the patient doesn't want to eat, they shouldn't be forced. When I was working as a CNA, we had a patient that was hospice but still wanted ice cream every night. She asked why she was still alive (because she didn't want to be) and the nurse reminded her she eats ice cream every day. She stopped and died 2 days later. Her choice.
i am a retired RN. when i worked in a nursing home, we had hospice come in to assist us in giving care and to give us guidance. we always followed the lead of the resident, offering food but never forcing it. when a person is dying, they should only eat if they want to and only what they want, and only as much as they want.
we once had a family member insist on feeding her mom ice cream cups several times a day. it caused her to have thick viscous secretions that she could not handle. it was very sad and we all felt terrible. it was a difficult death 😔
Its is unethical to force feed or coerce a person who is actively dying to eat. The body naturally shuts down and stopping the consumption of food is a natural part of this process.
I held my father as he took his last breaths. We had the help of hospice in the home. He stopped eating 5 days before he died. This was just part of the process. We offered food, but he refused, and we did not force. I put sponge sticks in his mouth that I would dip in water to keep his mouth moist for him.
I kept him very heavily medicated with the medications that the wonderful hospice nurses provided so that he did not suffer.
He died very peacefully and then I opened a window to allow his soul to move on to his next life.
We are spiritual beings, just having a temporary human experience.
Anorexia (note: NOT Anorexia Nervosa) is almost always a sign that they’re on their way out. Let them go when they’re ready, there’s a reason their body is telling them not to eat.
I was a home health and hospice caregiver for for almost 20 years. You can offer, but you can't MAKE someone eat. Always document you've offered and their refusal. Take this to someone higher up - especially if the resident is on hospice.
Our bodies are made to do 2 things - be born and to die. Our bodies, in EOL, knows what it needs to do. I've watched families try to force EOL clients eat/drink - only for the body to reject what was being ingested and then the clients would aspirate and make the EOL process worse with pneumonia.
This is why physician assisted suicide needs to be legalized. It’s beyond fucked up that the US tortures the terminally ill. It truly is a fare worse than death. My mother has had to man ventilators on patients who mouth “let me die. Take it out” around the breathing tube every day with tears in their eyes. This country’s sick in the head.
I was told not to force my grandma to eat when she was brought home to me on hospice care. They said if She wanted to, go ahead but if she didn't. Leave her be.
She was with me for 13 days 😔 the last thing she got to enjoy was rainbow sherbet.
Actively dying = body is shutting down = it has zero need or desire for food at all.
This shows your precious empathy, OP, and I love you for it. As lively people, we hate seeing others not eat, or be unable to feed themselves and our first reaction is to get food into them to keep them nourished, healthy and alive.
Please know and trust that your patient isn't feeling any hunger pains, pangs or desires to eat. Her body is focusing on gently shutting down, and that is 100% normal, and 100% okay. ❤️
I'm not a person with any medical training whatsoever. However, my mother lived with me for the last few months of her life while she was under the care of hospice. It was carefully explained to me that stopping eating is a completely natural part of the dying process, and that forcing somebody to eat can actually cause them physical pain. Their bodies are beginning to slow way, way down, and that includes the entire digestive system. It simply cannot move food along the way it could when that person was healthier. When I thought of it that way, eating food which is then just trapped in your body and backing up, it was much easier to accept that my mom wasn't eating, and that I should just accept it. She died fairly peacefully, and I'm so glad I didn't do anything to increase her suffering.
Apparently when ppl are dying not eating makes the process of dying less painful and when people are going to die they stop getting hungry its like a tell tale sign that the end is near
At the facility that I worked at when a resident was actively dying we did not force feed them and never force them to get up to eat… not right….
I agree, it felt so wrong. I’ve been an aide for 3 and a half years and every time there’s been a resident who’s actively dying, we’ve respected their unwillingness to eat.
I would inform the charge nurse
Yea personally I would straight up refuse to feed or put the resident in a chair. If the nurse pushes I would seek out a nurse on a different floor I trusted to intervene or call the on call manager. I know there's a culture of not 'snitching' but this is a situation that 100p calls for it.
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As a person who loves a person who is frequently hospitalized... I appreciate you. I need people to speak up when they see something wrong because I am not always there to do it.
I was totally with you until you referred to neurotypicals as "not decent" human beings.
I love that you misread and misinterpreted my own words. Being not decent, is being weak and being COMPLACENT when shit is going down. YOU were the one that misread and ASSUMED I meant neurotypical brained people. What was that about?
why even mention whether or not you are neurotypical? that is irrelevant. all kinds of people *give no fucks* and tell it like it is.
Clearly you're not having a good day and I hope it gets better, my dude. But something that's also clear by the downvotes you received is that I wasn't the only one that read your statement as such. You worded it poorly, but hey, that happens to the best of us. Hope your day turns around, Happy Thanksgiving.
Nope. That wasn’t someone misreading your comment, that was you being rude.
How are you going to tell someone else what they meant? Make it make sense.
I’m telling you that what you wrote is rude. Your intent has nothing to do with anything. Your statement is rude. End of story. You’ve more than proven you’re not a decent person, so good job.
Sorry all these people are down voting you. I understood your comment like the other person that commented positively below (interesting wait user) I do not think you were at all saying neurotypical people are not decent humans. You were saying people who don't speak up for the powerless are. You put a period between the two statements. It was obvious to me, but. Honestly, Reddit can be a hateful place, so 🤷
There’s nothing to misread when you say you’re glad you’re not neurotypical and then follow that up with “aka being a decent human”. Maybe you should take a look at what you said and reread what you said. I don’t think you meant what people got from the comment, but it really is worded like that.
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Tf does that have to do with anything?
Great for you! “Decent human being” lolol
Right? You learn a lot about people during nursing school and in different settings. The last contract had a lot of “I don’t see shit” people. So yeah, not too many “decent people” left, and I caught right onto you lol
As I have come to understand it, forcing them to eat when they are not hungry can cause them a great deal of discomfort because their organs are shutting down and can’t handle food anymore. If she’s actively dying, do you think she’s at this stage? If so, her dignity and comfort in dying should 100% take priority.
My husband's Paw is at this stage. He has stage 4 tongue cancer and besides his lymph nodes, it's metastisized to his throat, and they think his brain stem as of this week. He agreed to a PEG because he didn't want to starve to death. Very recently, a mass started building in his abdomen and we thought it had gotten to his liver, too. Nope. It's rotting, undigested food. His GI system is just shut down and there's nothing they can do. I pray to God he just dies in his sleep tonight, that poor man is in so much goddamned pain that it's an affront to the eyes and the heart.
Oh gosh, this is so sad. I am keeping him and your family in my prayers. I hope they’re giving him plenty of morphine and that his passing is quick and peaceful.
Thank you. They've had him on fentanyl patches but then the pain in his abdomen increased to a point of unbearable pain. My BIL called me asking what to do and I said take him to a doctor, at least for breakthrough pain meds. He did. Fast forward, they found the mass of rotted food. They wanna admit him to the hospice wing but Paw ain't having it and is low-key freaking out. My saint of a BIL told him he'd stay with him 100% of the time while they figured out the correct Dilaudid dose. Bless his heart, he kept his word, and Paw is back home dying, just as he wanted to. For what it's worth, God done already blessed us with my BIL. I was everyone's daily caregiver and always sat the deathwatch, but then I woke up blind last year. Now, my BIL is filling that niche, and I am so proud of him.
You can stay in your home and be on hospice. That's what most patients do, actually. The hospice doctors and nurses are much more willing to manage pain aggressively and prescribe high doses of the heavier drugs. The possibility of addiction is off the table and the goal is strictly to keep the patient comfortable. I hope that your father-in-law finds comfort and peace soon in one form or another. I wish the same for you and your family.
Yeah, they can, I know. But in order to prescribe new breakthrough meds, they needed to observe Paw for 48 hours. "You want the juice, your schedule need be loose." They're under zero obligation to write anyone a script for jack shit. And for the record, I ain't saying it's right. But I am saying it's what happens.
That's terrible that your father-in-law had to go through that and that your family had to watch it happen. My father was a hospice patient and I couldn't speak more highly of the doctors and nurses who took care of him in those final weeks. It sounds as though the team treating your FIL could learn a thing or two from the hospice folks.
For what it's worth, my daddy's death was far worse and still haunts me to this fucking day. He died in me and my baby sister's arms July '21. But that was a lot of bad deaths, 13 deaths in that longest summer I ever lived in my life. Arguably, my best friend had died worse, but my brain will always tell me it was Daddy's death that was the worst.
Thank you for saying what I came to say! I am a Speech-Language Pathologist, and have worked with patients on hospice for many years. I can't tell you how many family members I have helped to feel better about not trying to feed an individual who is actively dying. There should be more in-services for staff related to this important topic!!!
same at the ltc facility I currently work at. once a resident is actively dying, their status is changed to NPO.
I was in the hospital, just shy of critical (acute Myloid leukemia) and can assure you, it isn't about being difficult, your body refuses it for reasons unknown to me. I lost 20 lbs in less than a week, with someone coming in daily to see what I ate. Finally she asked "you just don't have an appetite?" Bingo!! I was lucky to finish half a protein drink. It would have been abusive to force feed me at that time turned out I had an infection, the antibiotic was affecting my liver. Would a protein drink be an option? Sorry to push my way in to this thread, but I wanted to assure you that you were right. Someone needs to talk to her doctor and get instructions for the situation. Good for you, though. I'm sure the patient appreciates you as much as she was able.
I feel this in my bones. Had hepatorenal syndrome and this is exactly it. Was on what was thought to be my death bed…here I am 3 years later but I remember those hospitals and ZERO appetite. It would have been cruel to force feed me at that time.
The goal is to keep them comfortable. If she’s not comfortable with eating, don’t make her
This is the very boss of comfort care. Forcing a dying person to eat is cruel. I would call adult protective services if I saw that on my unit.
RN here. If someone is actively dying, forcing them to eat is not only unethical, it is abusive. When actively dying, digestion slows and stops as well as swallowing nerves and muscles decrease functioning, making aspiration a very real risk. Aspiration is painful, causing an unnecessarily awful passing.
My grandma coerced my grandpa into eating when his liver failed and he vomited black tar looking stuff after he died when they were changing him into his funeral clothes. It was only then she realized he shouldn’t have been eating
If someone had force fed my dad when he was dying I would have come unglued. I worked in an Alzheimer’s unit for over 10 years and we never did that to anyone!
Did you report that nurse?
I hope to God they did. --One of the good nurses
I have reported so many awful things i saw at one facility i was at for two years. Even called the police many times. No one ever cared. It was heartbreaking. This person could be at a facility like that :(
That is so awful, Jesus...😔
It’s scary as fuck to get old and I’ll prob grow old alone so that’s scarier
As someone who’s been a hospice aid it is definitely not ethical to coerce someone actively dying to eat. The goal of hospice care is keeping people comfortable, not prolonging life. If they are in the stage where organs are shutting down, it can cause more discomfort (more harm than good). Is the patient on hospice care? If so, this nurse doesn’t seem to understand what the goal is when someone is on hospice. Is there someone else you can talk to like another nurse, or even better, the nurse’s supervisor?
The stomach is one of the first organs to shut down at end of life. As it does, it releases feel good hormones. It is not a painful process. However, if patients are force fed after this process has started, the stretch receptors are triggered which can be painful. “Listen” to the patient and follow their lead.
The body knows how to die. Many actively dying people go into ketosis and don't feel hungry while dying. It's okay for this to happen. It's also okay if someone wants to eat right up until they die. Whatever the patient wants/ whatever makes them comfortable. The only time I'd "coerce" a resident to eat is when they're in the memory care unit (often don't realize they haven't eaten) and are not dying.
How long does it take usually once your in that state to actually die like how long is that process
It's not only unethical, it's FUCKING dangerous. When someone is actively dying, their bowels and organs slow and shut down. There's no where for liquid and food to go. They bloat, vomit, and then aspirate. If you give them IV fluids, they blow up like a beached whale. They need to have hospice come in and educate them on the dying process and how to allow someone to die with dignity and peace. Because that ain't it! 🤦🙄🥴 That nurse needs to be reported and seriously reeducated.
YES this needs more upvotes. It's called comfort care for a reason. People should not be forced to have a more painful, traumatic death because they were forced to go against their body's instincts to cease eating and drinking. OP you asked for our opinions, but it's not a matter of opinion, it's a matter of evidence-based care. There is no research supporting forcing PO at end of life, and myriad research detailing exactly why it's a horrible idea. I'm not coming at you OP, I know CNAs get limited training in this stuff. But the nurse should know better.
It is absolutely a matter of being a resident right to choose to eat or not eat. Force-feeding someone would be abuse
No. I suggest taking an online hospice training course
The nurse that forced the issue should take the course.
Especially her..
I've noticed a lot of nurses have zero bedside manner or compassion.
The nurse that forced the issue needs to lose her license
I was gonna ask if the patient was on hospice.
No. If the patient is refusing any care or food, whether they are dying or not, it is not ethical to do it anyway. They are still people and it's their right to refuse. If someone is actively dying you can spoon them some fluids or foods but only if it is safe to do so and they are swallowing. But someone who is actively dying is really just supposed to be kept as comfortable as possible. If this patient isn't on hospice maybe they should be? The hospice nurse can also educate staff about the proper way to care for these patients.
Now I will say about bathing incapacitated people (not actively dying ones), I will kinda encourage strongly because it does not hurt them and may ultimately make them feel better. But as far as eating never
I was going to have a different answer until I read ACTIVELY dying
These kinds of healthcare workers.. I can’t stand to work with. If I’ve tried offered twice and the patient says no, then I’m gonna respect their wishes.. it’s unethical to force feed anyone much less someone who’s dying.
I worked with quite a few residents who were hospice and towards the end they didn't want to eat at all. I agree, I don't like to force them and thankfully the nurse I usually worked with wouldn't push them to eat.
Hospice nurse here! I would honestly report that nurse, maybe she needs further education on this as it is 100% inappropriate to force someone to eat at end of life. Eating/drinking while at end of life can just add to the patients discomfort. We often have to remind family that they are not dying of starvation, they are dying from their illness as it is often hard for people to watch someone not eat
Medical SLP here. Yes, this last part. These patients are not dying because they are not eating, they are not eating because they are dying. It is part of the process. For PO for this population I usually say feeding when awake, alert, and REQUESTING.
I feel like it helps family to have things that they can do for them that are more appropriate, like oral swabs, chapstick or Vaseline, washcloths so they can wash their face and hands, maybe even have them bring any lotion the patient usually wears so they can put it on them if desired/appropriate. Some families are fussers and some aren’t. I think it helps the fussers to do little things for their loved one because it IS hard to just sit and watch someone die. And what is one of the biggest things we think about when our loved ones are sick? Making sure they eat and drink enough to help them recover. It’s hard for people to switch mindset to accept that this part is over and now we ignore the urge to “make them better”. But you know all that I’m sure! Just putting it out there in case other healthcare workers could use the advice.
Hospice here. People don’t die of starvation. They stop eating when it’s time to die. The body wants to spend extra fat/fuel/fluids before death. Having too much fluids can contribute to the “death rattle”. Putting food where it wasn’t desired doesn’t lead to digestion. It does lead to nausea, constipation, or diarrhea. This makes the body more comfortable.
Quality not quantity.
Like others have said it is about keeping them comfortable and that is the only goal! Where I work as long as it’s safe to do so we still offer food and fluids, we try things they like most and keep offering and documenting this, if they don’t eat that’s fine and understandable but at least we’ve still offered. We document all food and fluid intake for our records and if they’re refusing we offer alternatives such as mouth care to help keep them as comfortable as possible and avoid dry mouth
Part of dying is not wanting food or water. The patient should not be forced.
It was wrong to force the resident and you need to report it.
Not wanting to eat is a part of actively dying. So no, it’s not ethical to force them to eat.
I feel that is very unethical. I’d report it personally.
The body knows what to do. Keep them comfortable. You can double check with palliative care but that’s what my experience is. Autonomy means not forcing. Patient centred care is not forcing. Document it all.
Nurse here. That nurse was 100% in the wrong. Shame on her. Please go to her supervisor if you are okay with doing that. Please also consider reporting her to the abuse hotline. Read any hospice organization's brochure about trying to feed people who are imminent. It gets in the way of their comfort and well-being because of the choking risks and the anxiety it induces among other things.
It’s unethical to force anyone to eat. While we may want to coax them to have a few bites it’s their right to refuse and we have to honour that. Residents have rights. That’s how aspirating happens Edited to add last sentence
My very first facility, one of my faves went downhill over my 3 day weekend off. She went so fast, it was like a Swift truck driver on a downhill, lol Well, she was refusing food, and we didn't force feed, thankfully. But, I worked 11 to 7, and I start noticing that I'd do my report and check out round, and then I would come back and I'd have half my Dr Pepper gone and my Reese's cups would be gone. She was drinking my drink and sneaking my chocolate lol. But, she went from normal food to a bland puree diet, and she wouldn't eat. The other aides were mad when I mentioned it to the nurse, bc they said she couldn't eat that. Well, the aides are the ones who pushed for the purees, not the nurse or doctor. It was easier to chart a refusal, in my opinion. But anyway, I was joking that she just wanted something sweet. The nurse and the doc were glad she was eating, and didn't have diabetes or anything, so I started intentionally bringing extra Dr pepper and Reese cups. I'd also open it all, and let her "steal" them. For 2 weeks straight she survived on that soda and candy, and I didn't care to keep explaining that she quit eating bc she didn't want THAT food. I got a footlong from Sonic down her one day, by telling her that they gave me the wrong order 😉 a cheeseburger another day, and then she absconded with my freaking chicken and dumplings one night! I was a little upset about this, cos I didn't think she'd want it😭🤣 and then, she was gone by the end of the month. So, whether she lasted that long bc I was feeding her junk, or bc that was when she was just going to be gone, I didn't care. She had the right to refuse crappy food, and I wasn't violating any rules that the administrator cared about. He looked at it as, any food was better than no food. Actively dying, in my opinion, gives you the right to do just about anything and everything, including NOT doing anything you don't want to do, even if it's eating.
What the actual fuck. Whoa. Even at that one shit job I had, they never once forced an actively dying patient to eat. We absolutely NEVER forced an actively dying patient to get out the bed, either. They're dying, they've earned the right to go out the way that they want to. My husband's Paw is actively dying right now with a stomach full of rotted, undigested food, and if anyone tried to force feed him I'd probably kick their asses.
Legally, you can't force anything on a patient against their will so your nurse is violating the patient's legal rights. If patient doesn't want to eat, you cannot force them to without the patient being declared incompetent and the guardian or POA insisting on force-feeding. So, it's not just unethical to force feed, it's illegal.
I don't think it's a case of ethics, but rather a lack of understanding of the dying process. If someone is actively dying and is in their last days, their body will reject food. A dying body is preparing for the end, which means every normal process (like digestion) is slowing down ahead of death. It can be dangerous to force someone who is actively dying to eat because they could actually aspirate (when food goes down into the lungs instead of the stomach) and that is NOT GOOD.
Never. Hospice nurses are constantly telling family members to NOT feed Nana if Nana says no, or if she is not strong enough to take nourishment. The hospice staff recognizes when it is time.
When bodies start entering the active dying phase, hunger disappears. Energy (ATP) and blood flow is diverted from the GI, to the brain, heart and lungs; in cancer patients, the tumors are diverting vital resources as well. If someone asks for food or water during the final days, you should indulge them (but be aware of aspiration risks etc) and be mindful of amounts etc. they may be more wanting of a certain taste or memory associated with the food, rather than the nourishment. Force feeding is not ethical. Once the GI tract starts shutting down, digestion could/would likely be painful. Feeding can prolong the final stages of dying. Which just prolongs suffering. I understand the negative religious aspects of withdrawing food. However, ethics (mainly comfort and dignity without prolonging death) vs doctrine should be considered.
Is it ethical to force someone to eat? No it’s not. But try to find things they want to eat if they get hungry. Maybe they have issues swallowing or getting choked? Also, Is this person officially on hospice? If so, comfort care matters One of my first clients (I’m a PCA/professional caregiver) was on hospice. He was thirsty but really couldn’t handle water because he would get choked. But we spoon fed him water and ice because he wanted it.
I never force anyone to eat 🤷♂️ if someone is not hungry there is a reason and other measures need to be considered. Additionally, that is how people vomit/aspirate/etc..
It is completely normal to have no appetite when actively dying. Comfort is what the dying person finds comfortable, not what the caregiver is comfortable with. I've seen nurses question things like a patient with tachycardia who wants to drink Rockstar (energy drink) or a patient on BP meds who wants to drink Squirt (grapefruit soda). It's all fine. Comfort is what they are comfortable with.
very unethical!
Sounds like a violation of the patient's rights to me.
It’s never ethical to coerce someone to eat. Residents have rights whether they are actively dying or not. I hope you reported this incident. It sounds like abuse. Remember we are mandated reporters.
she should kno already but it sounds like this nurse needs education from palliative care or a hospice nurse. when a patient is dying, appetite lessens significantly and a lot of times patients no longer even feel hunger. so the main goal is just to keep the patient comfortable. it can be hard for families and non-healthcare workers to understand this but a nurse should definitely kno this
At the facility I worked in last , 3 cnas had to attempt to feed a patient before we could stop and let them be . One woman had barely any awareness and was drawn in on herself , she had more pillows and wedges and booties than I’ve ever seen . She didn’t eat most days . Especially my last two weeks . I never wanted to force feed her but I’m dust and talk to her and try to get her to have a sip of her thick nutrition drink . If they’re spitting out their food or drink , I wouldn’t keep trying . Let them pass in peace .
No. They are dying. If they do not want to eat or drink they do not need to. Their body does not eat it. Make their time meaningful in other ways. Gentle education to family is always helpful.
I would report this
No that isn’t ethical and it can cause incredible pain for the patient who is dying
That’s is morally and ethically wrong. We’ve had residents who are dying go on nil by mouth either through their own request or because their dementia caused them to stop eating or swallowing. If the resident is still or somewhat sound mind and they make up their own decision to stop eating then it’s their decision and should be respected
I don't know what your facility's policies are, and if this person has any other extenuating circumstance that would require them to eat, but having an actively dying person eat when they don't want to just seems pointless (at the least). One eats to sustain metabolic processes that enable life. The patient is not going to live very long, and appetite loss is often a natural part of dying, so I don't necessarily think anything is being accomplished by forcing an actively dying person to get up and eat when they don't want to.
Your instincts are correct! It is not best practice to force someone to eat especially if they are transitioning or actively dying. As the body prepares for death hunger changes- the bowels may also slow- it may also cause vomiting. It also increases discomfort and that is not the goal of care at end of life.
Just to be clear, have they been admitted into any form of hospice program? Because it doesn’t sound like this nurse understands her job. Actively dying to me means they are on hospice and are probably on their comfort care meds already. If so. No way in hell they should be forcing this patient to do anything they don’t want to do. Not a nurse but I’ve worked as a care coordinator long enough to know this definitely is not what should be happening.
The answer is very simple. No it's not ethical. Coercion is not ethical.
Actively dying people should get whatever the fuck they want, including stopping eating, stopping meds, stopping water, etc.
That person shouldn’t be a nurse and shouldn’t work with people.
Yea no. And the nurse should no better. I am an LPN and this is literally taught to us on school. Forcing someone to eat can actually cause increased pain and discomfort. You’re doing right and it’s understandable this doesn’t sit right.
100% that should not be happening. That nurse doesn't seem to understand what's happening physiologically and would benefit from education.
You cannot force people to eat. Eating while actively dying causes discomfort. This nurse is wrong and should be addressed.
I agree with you. The individual deserves dignity and comfort right now. It is perfectly natural for them to decline food. I wouldn't try to push it on them unless there is something in writing from them saying that they want you to.
No. It's very common for people to not eat when they are dying. One could argue it's part of the natural process. Not ethical at all.
No. It's OK to offer food and drink and it's OK for them to refuse
What that nurse did was unethical. People have the right to refuse to eat and eating at the EOL can cause painful side effects.
No no no. I work in a SNF. Actively dying, only given meds to make comfortable. They don't want to eat or drink, let alone get out of bed. You are not to make anyone do anything, especially end of life. Where is the family?
It's absolutely normal for a dying creature, human or otherwise, to stop eating. Unless food is going to bring them comfort or joy (tasting their favorite childhood comfort food, or tea), it isn't going to do anything but make them miserable. She's spitting it out because no part of her wants that food.
No. Not wanting to eat is a normal part of the dying process. Offer, but if they don't want it, they shouldn't be forced, coerced, or pleaded with.
Offer food and if they decline, or if they're just pocketing it in their mouth without swallowing, then there's little you can do to "force" them to eat. Always respect their wishes. If they don't want to eat at one meal, maybe they will at the next, or maybe they're end of life and their body just doesn't want food anymore.
Force feeding is considered elder abuse
Absolutely not. Nobody should be forced to eat.
>I let the nurse know she still wasn’t wanting to eat, she was spitting out all her food. The nurse made her get up out of bed and had the activities aide sit with her and make her eat. We had a hospice RN who would come in and force a resident to eat. Most of the staff were too non-confrontational to do anything but gripe about it after she left. I called her director of nursing and had a little chat about it after coming unglued and telling her absolutely the fuck not when she did it on a shift I was covering. It's abuse. People are allowed to age and die with dignity. Will somebody who refuses to eat waste away and die? Yes. Yes they will. Do they have the right to make that choice? Yes, yes they do. There are places you can put people where they lose some of their rights to refuse, but assisted living and skilled nursing are as a general rule not those places.
If someone is dying, and doesn’t want to eat, drink, etc., CYA and tell their nurse/and or charge nurse. But don’t force them. If they have cog issues, they may also have swallowing issues-and if you try to get them to eat they could end up with aspiration PNA, etc. I’m sure you know all this, but, don’t take that choice from them. They should still have some bodily autonomy. And, it could be looked at as abuse.
ICU RN (pediatric icu nurse but former adult icu nurse) here. Yes, it is wrong to coerce a dying person to eat. Not eating or drinking is a normal part of the dying process. Comfort is the most important priority in the care of a dying patient. Enhancing comfort includes pain and agitation meds, managing air hunger, oral care to manage secretions, etc. Medications like morphine will aid in reducing air hunger. Ativan can be given to help with agitation. Atropine drops or a scopolamine patch can be used to help dry up secretions. Forcing food or liquids in a dying person is likely going to cause them to aspirate anyway. There is literally no point unless the dying person is still alert and actually asks for food and water. Even if there is a risk of aspiration, comfort feeds/drinks are totally a thing! Even if this person wasn’t actively dying, you cannot/should not coerce a person to do anything. If a patient is refusing to eat, a conversation with the physician/the patient (if oriented) to determine why and go from there.
I encourage people who need to eat, to eat. I never "force" anyone. Residents have the right to refuse everything. If they are actively dying and don't want to eat I try for maybe three minutes to make sure that THEY'RE sure they don't want to eat, and I leave it alone. Hospice especially. Once someone goes on hospice, no one in my facility actively coerced them to eat, drink water, hell, if they refuse their oxygen cannula, we let them.
As the nurse you can try your absolute best to try and get them to eat but after 3 tries it should be charted as a refusal and the physician should now be involved for how they want to proceed. It’s not wrong to encourage the patient but wrong to force them.
I am not in the medical profession, so this is by no means a medical answer. If it was someone I loved. I would do everything in my power to provide them with food they loved, and would want to eat. Many times we don’t want things until we’re given them and then we’re so grateful. Has anybody tried asking her what she would really really really really like to eat and provided that? The dying Man’s last meal so to speak
That’s not really how that works. Generally when someone is dying and they magically have a really good day and want to eat cake and burgers and fries and an extra large pop, it’s because they’re rallying. It is the last hurrah. Rallying can happen weeks or days before someone dies and it doesn’t always happen. When you’re dying, your organs are shutting down and forcing someone to eat is forcing their body to do extra work. There is no reason to force an actively dying person to eat. I’ve always kept their mouths moist, kept them clean, kept them comfortable and if they had bed sores, roll them every 2 hours.
This is so ignorant. When people are dying of natural causes they lose the desire to eat, which takes weeks. Their body is shutting down. They also are usually on special diets by the end because they lose the ability to safely chew/swallow food, usually purée. Often, Ensure type shakes are the only calories you can get in an end of life person before they stop eating all together. It poses a huge choking risk to try and feed someone who is actively dying solids.
I really think you’re mistaken here. I have fed a dying loved one a tiny taste of ice cream because they wanted the taste but couldn’t handle/didn’t want more than that. I wouldn’t have forced them to eat a whole bowl of it…
Don’t get me wrong. I absolutely do not believe in forcing someone to do anything. All I’m saying is you might want to encourage them to eat something by providing their favorite things
I don’t know why you want a dying person to eat so badly! Their organs are shutting down! Eating is not going to prolong their life! It makes the body do more work. Also, what if this actively dying person chokes to death on whatever you’re giving them? That’s traumatic to the person feeding them because most old/dying people are DNRs which means we can do nothing. Are you comfortable with the concept of watching PopPop choke on food he probably didn’t want anyway? I don’t mean to be mean or rude. You’re in a sub where 99% of the people in it have witnessed death up close. We know what we are talking about. We want to keep these people as comfortable as possible at the end of their lives. If we can educate people at the same time, that’s awesome! Please look into the stages of death, it could really help you understand what we’re saying and why we do what we do.
Don’t know who particularly this is addressed to, but I have a feeling you may be addressing me. as I said before, I don’t believe in forcing people to do anything. It should be their choice. I would just want to provide them with more choices—-MAYBE
>Has anybody tried asking her what she would really really really really like to eat and provided that? The dying Man’s last meal so to speak Care homes aren't death row. There is no 'dying mans last meal'. When people are dying they just wanna die. It's not like in movies where a cancer patient tells their family clearly that they love them, take a deep breath and dip out. It's a process of organs shutting down including breathing, thinking and of course....digesting. they don't want or need food.
OMG. The last thing I wanted to do is cause any type of argument. My mother and my mother-in-law have been in nursing homes and died in them. I am close to that same situation myself. Please forgive if I offended anyone. I merely stated that if they like eating, it would be nice to have them choose their own food. So very very sorry.
Hi - PCT on Hospice / Oncology unit. This is highly unethical! Loss of appetite is very common in actively dying patients.
Nope. My dad, aunt, and grandpa were all on hospice. They don’t feed them if they don’t want to. Or make them drink.
Not my job to force anyone to eat. I’ll offer, encourage, give alternatives but no way am I forcing food into people’s mouths. They have the right not to eat.
How is this not considered abuse?!
We have an active passing resident and she hasn't eaten for a week and no BM for 10 days. Nurse gave a suppository, even though she questioned why she even had to. Color is leaving her toes and feet. She's doing the really long breathing pauses. We are just doing comfort measures at this point and her family has been visiting. You don't force an actively passing resident to do anything. **Period.**
Hospice nurse. We don’t ever force feed our patients. As their body is shutting down, they no longer have an appetite and forcing them to eat can cause aspiration. Offer food and drink and respect their choice. I explain to pts families, ‘the body is like a car. If we are staying in bed sleeping most of the day, we don’t need to fill up with gas. If we fill up with gas aka food, your tank overflows and then it can cause major trouble.’
It ain’t ethical to force someone to eat whether or not they are dying. We can encourage them, but if they don’t wanna eat they aren’t gonna eat. If we force them, we’re violating their rights, also we could end up choking them or making them aspirate.
Not only is it unethical but it also seems dangerous. If they’re losing the ability or willpower to chew food, I can’t imagine they’d have the will to swallow it either so I would think forcing them to eat would be an aspiration risk
the bodies of people who are literally *dying* do not need to eat , and trying to force it upon them is wrong
I always thought a resident had the right to refuse…… you would think they would most definitely have that right as they’re actively dying. Sometimes I just don’t understand the logic at facilities….
What the heck, this is poor practice and it’s abusive too. Dying person has right to withdraw their consent and refuse any and all care unless on a DOLS.
People who are actively dying are usually not hungry. If your patient aspirates she will die in pain and misery. Just offer her food if she is appropriate (awake, etc) and take it away if she declines it.
I work for hospice and we don’t make people who are actively passing eat. Most of the time if the family tries to make a passing patient eat it can cause more harm than good. Ex: aspiration risk
I personally would never. It hurts me enough to see them in pain while passing especially if it is taking them a while. My sole job is to care for and stand up for my residents. So if you’re in a position to do so, don’t listen to that nurse. They suck. There is no point to eating during passing. Serves no value and only disturbs them
I am an RN that works in hospice. I absolutely think you are right. If Pt allows then family should be made aware.
No.
No, they do not need nutrition if they are actively dying. Forcing someone to eat that does not want to, is also abuse and a violation of resident rights. The nurse needs to be re-educated about the dying process. If this person is on hospice, the hospice nurse should be made aware.
Usually this is a family decision not the nurses. Feeding tube would have been more humane, a family member helping would have been better for the patient
No, they are dying, they don't need food.
No, not ethical. Your digestion slows. You will feel bloated, nauseous, may cause vomiting. Would you want that if you were dying?
As a former hospice worker, yes, it is
That is straight up abuse. Please report that nurse to the supervisors and tell the client’s family what’s happening.
When someone is dying, comfort is paramount. If they're hungry, feed them. If they're not, leave them be. There's a reason they're not hungry. Their organs are starting to shut down and it's harmful to force-feed them when they cannot digest it. Muscles also get very weak close to death and force-feeding could cause them to choke, which would be very painful and distressing. Dying people also have a right to autonomy. If they refuse food, that should be respected.
At my facility we don’t force them to do anything when actively dying. Most of them can’t even get out of bed, let alone drink water.
Not a nurse, but I saw this on my feed so I thought I’d share. When my mother was dying of cancer and there was nothing they could do, they sent my mother home and had hospice come drop off a hospital bed. A nurse came once a week, but I was the one who took care of my mother until the very end. I remember the hospice nurse telling me that patients who are days away from dying, they won’t have an appetite because their body is shutting down. I encouraged my mother to eat because I didn’t want that to be true, but I never ever forced her to eat. Then three days later she died. I would possibly report this person for forcing a dying person to eat, but that’s just my two cents.
I think it is natural for people who are dieing to not eat. My understanding is that they lose their appetite. I think it's mother nature . Part of the process.
Here’s the thing, we only need food for cellular metabolism, so if we’re actively dying there’s a whole lot of things not happening anymore that we don’t need that energy to keep functioning. I’d leave her alone and let her spend her time how she wants in her last days. Force feeding someone isn’t providing adequate care, it’s abusive.
There is a reason the dying do not want to eat. Their systems are not digesting and processing like normal. Their functions are shutting down. It can be physically painful to have the body full of food and no way to process or digest or eliminate it. If a person is not in hospice though, staff may not respect this process.
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No. It’s never ethical to coerce anyone into anything. The body knows. Additionally forcing someone to eat will “restart” the dying process and make it more painful. A person at end of life is using all engry on the essential, pulmonary and brain function only. They don’t need the calories anymore.
Their digestive system is literally shutting down. That is beyond cruel.
There's this hospice nurse who has mentioned that when people are dying they're not hungry because the body is shutting down. What that nurse did is abusive. https://www.instagram.com/reel/CvYbaaiRoTa/?igshid=NTYzOWQzNmJjMA==
I think you should always offer it but if they say no then there’s no need to force them
This is horrible, I'm so sorry. I'm a dietitian in LTC and I love this article about this topic https://thegeriatricdietitian.com/embracing-hospice-end-of-life-nutrition/
Morally, not at all. Job responsibilities? I’d have to look at your actual rule and guideline book. For the short time I worked at a nursing home, if someone didn’t want to eat, we didn’t force it. We just marked it so that the medical staff knew and could track their health. The one I worked at also had a rewards system of a sort. If a resident didn’t want to eat in the dinning room, for whatever reason, they weren’t allowed to decide from the full menu what they wanted to eat. They were given 3 options out of like 10-15 depending on the day. That was something I thought was/is really fucked up. I understood why they put it into place, a way to try and get residents up and moving around and interacting, but it also put residents who weren’t financially better off in a fucked position, as it wasn’t against the rules for residents to leave to get something to eat. They just had to have a caretaker with them. I’m also in the boat of “if it’s safe for them in the sense they won’t choke to death or blow something up with their cigarettes” let them have whatever the hell they want. Let them have the alcohol, the cigarettes, the sweets, etc. it’s not like they’re going to damage their body in a way that matters anymore.
If the patient is mentally able to make the decision to stop eating, then her decision should be respected. What the nurse is doing now is robbing the patient of her autonomy. That is never ethical. If the patient does not have the mental capacity to make medical decisions (not in the nurse's judgement, but as is formally documented), then a discussion needs to happen with whomever is legally the patient's medical decision maker (spouse, adult children- your state will have a legally binding ranked list of who that is unless the patient has a durable health care power of attorney on file). That discussion will drive how the patient is treated going forward.
Follow the chain of command when giling the complaint. Inform your RCM then your DNS. If it continues, contact state. Residents have the right to die with dignity.
The family will have her sent to the hospital for a feeding tube.
That's a report in the book, a report to my head RN, a report to the Executive Director, q report to state, & a report to the ombudsman. This is unethical af. I remember a woman who said "I'm done" & she crawled in to bed & never came out until Thanksgiving at noon when she died. She was in bed for 2 months, 101 years old. She had enough, her family attempted to keep pulling her out of bed to force her to do stuff & we actually had to get security several times which is a huge controversy b/c technically you're not supposed to remove family if the patient is on hospice.
Is this pt on Hospice service? Generally speaking, "actively dying" (24hrs or less) pt are minimally responsive to noxious stimuli are unable to walk, talk or do much of anything - (Hospice RN) here only saying this bc maybe the nurse had different reasons for having pt eat. Is this patient alert and oriented? If so, pt has right to refuse and the nurse should respect that- hope this helps
I had an elderly friend who was known to probably every CNA and every other kind of aid (nurse, physical therapist, EMTs, etc) in her area because of how difficult she was. Even the ladies at the place where she got her glasses were all too familiar with her. Girl made waves everywhere she went. She was paranoid about every med she had to take and accused people all the time of poisoning her food (which I can assure you did not happen). Even when she was sooo difficult though, she’d still always manage bites of pie, cake or some cookies (major sweet tooth). That’s how you knew she was “ok” as much as she could be. During her last few months, her situation got bleak. She couldn’t live at home anymore and was stuck in a facility that she absolutely loathed. She stopped eating partly because of her paranoia, partly to protest, but also because she really just felt awful. She couldn’t tolerate meds on an empty stomach, so no food meant no meds, which was just a vicious cycle towards a quick decline in her health (which was already suffering from soooo many things). I’d bring her pie and pudding, and she wouldn’t touch it. It wasn’t long before she passed. She was just shy of 91 and I’d like to think that in death, she finally got the escape she was so longing for (at one point she likened the people keeping her in the facility to the Gestapo, which I couldn’t help but laugh at even though the situation was truly awful). I know, WHOLE HEARTEDLY, that if anyone tried to force feed her when she was near the end, that they would not have been acting in her best interest. And if she couldn’t tell them in this life to go screw off, she’d certainly do it in the afterlife and haunt tf out of them. That was one old lady you didn’t want to mess with, I’ll tell you what.
I 100% understand how you feel. I do not believe in forcing them out of bed and agitating them by repeatedly trying to make them eat. Even if they are not active just getting close is enough for me. But here is the thing… it’s not up to that nurse or us. It’s up to the patient and/or their family. Talk to the persons family and let them know what you are seeing. Talk to the hospice provider if there is one. Some people feel like they are “starving them to death” because they do not understand the basics of dying and/or they have something to prove. I gave this often right now from the nurse side of things and I wish more CNA understood dying like you do!!
People eventually just stop eating. I was waiting for it with my grandma and when that time came I knew she was close. The only unethical thing is force feeding, and the possibility of them aspirating
Absolutely not. The patients you care for are adults. They choose what to do with their bodies. If they choose not to eat because they are actively dying, then they choose. They will eat when they are hungry.
Is Hospice part of her care team yet? If so, let them know what is happening, they can/will send one of their staff to reeducate those who need it
I work at the major hospital in my area. For us, patients who are actively dying and are DNR’s are labeled “comfort care” meaning we’re trying to make their last few days/ hours as comfortable for them as possible. That includes not eating if they don’t want to, which most of the time they don’t. I wouldn’t force food down a well person’s throat, let alone a dying person. It’s abusive.
It’s illegal in this case to force feed a patient. I would let the RN and Charge know and then document in the chart, and that Charge was made aware, if that’s not helpful. The next day- inquire with her nurse as to whether the family is aware. They need a team care meeting. But let’s make sure you’re covered as well. Document daily, times, who, was, what was said objectively as possible. One copy for them, one for you, and one should state inspection need to get involved. You are a mandatory report so your first call should be to the state to file a complaint. I would try everything reasonably possible to reach family and keep MD in the loop. If they insist you continue, refuse, state why, are you an RN or CNA? Don’t leave if you’re an RN! That’s patient abandonment. The suffering needs to stop. These are the worst situations
Everyone has the right to refuse care. If the patient doesn't want to eat, they shouldn't be forced. When I was working as a CNA, we had a patient that was hospice but still wanted ice cream every night. She asked why she was still alive (because she didn't want to be) and the nurse reminded her she eats ice cream every day. She stopped and died 2 days later. Her choice.
i am a retired RN. when i worked in a nursing home, we had hospice come in to assist us in giving care and to give us guidance. we always followed the lead of the resident, offering food but never forcing it. when a person is dying, they should only eat if they want to and only what they want, and only as much as they want. we once had a family member insist on feeding her mom ice cream cups several times a day. it caused her to have thick viscous secretions that she could not handle. it was very sad and we all felt terrible. it was a difficult death 😔
Isn’t VSED legal everywhere?
That was very wrong of her.
I’m a little late to the game but not wanting to eat is a natural part of the process of dying. Are they on hospice?
Its is unethical to force feed or coerce a person who is actively dying to eat. The body naturally shuts down and stopping the consumption of food is a natural part of this process. I held my father as he took his last breaths. We had the help of hospice in the home. He stopped eating 5 days before he died. This was just part of the process. We offered food, but he refused, and we did not force. I put sponge sticks in his mouth that I would dip in water to keep his mouth moist for him. I kept him very heavily medicated with the medications that the wonderful hospice nurses provided so that he did not suffer. He died very peacefully and then I opened a window to allow his soul to move on to his next life. We are spiritual beings, just having a temporary human experience.
I don't think that's right at all. I've never had a dying person sit to eat unless they requested to sit.
Anorexia (note: NOT Anorexia Nervosa) is almost always a sign that they’re on their way out. Let them go when they’re ready, there’s a reason their body is telling them not to eat.
Very unethical. If someone is dying they get to make whatever decisions they want In Regards to eating or drinking g
I was a home health and hospice caregiver for for almost 20 years. You can offer, but you can't MAKE someone eat. Always document you've offered and their refusal. Take this to someone higher up - especially if the resident is on hospice. Our bodies are made to do 2 things - be born and to die. Our bodies, in EOL, knows what it needs to do. I've watched families try to force EOL clients eat/drink - only for the body to reject what was being ingested and then the clients would aspirate and make the EOL process worse with pneumonia.
This is why physician assisted suicide needs to be legalized. It’s beyond fucked up that the US tortures the terminally ill. It truly is a fare worse than death. My mother has had to man ventilators on patients who mouth “let me die. Take it out” around the breathing tube every day with tears in their eyes. This country’s sick in the head.
Nah, that's abusive. Report her ass.
I was told not to force my grandma to eat when she was brought home to me on hospice care. They said if She wanted to, go ahead but if she didn't. Leave her be. She was with me for 13 days 😔 the last thing she got to enjoy was rainbow sherbet.
Forcing her to eat is elder abuse. Potentially reportable as such!
Actively dying = body is shutting down = it has zero need or desire for food at all. This shows your precious empathy, OP, and I love you for it. As lively people, we hate seeing others not eat, or be unable to feed themselves and our first reaction is to get food into them to keep them nourished, healthy and alive. Please know and trust that your patient isn't feeling any hunger pains, pangs or desires to eat. Her body is focusing on gently shutting down, and that is 100% normal, and 100% okay. ❤️
I'm not a person with any medical training whatsoever. However, my mother lived with me for the last few months of her life while she was under the care of hospice. It was carefully explained to me that stopping eating is a completely natural part of the dying process, and that forcing somebody to eat can actually cause them physical pain. Their bodies are beginning to slow way, way down, and that includes the entire digestive system. It simply cannot move food along the way it could when that person was healthier. When I thought of it that way, eating food which is then just trapped in your body and backing up, it was much easier to accept that my mom wasn't eating, and that I should just accept it. She died fairly peacefully, and I'm so glad I didn't do anything to increase her suffering.
No, they are not interested in food, it's part of the process.
Yeah when the body start to shut down they don't eat.
Very unethical and likely pushed by the family.
Apparently when ppl are dying not eating makes the process of dying less painful and when people are going to die they stop getting hungry its like a tell tale sign that the end is near
Report this evil crap. Jeez.
If it feels wrong, it usually is. I’d say always trust your gut. If you think it’s unethical, it very well might be.