Making up for last week

So here I am and I just realized I neglected the blog last week... Thinking back, I think one of the most valuable learning experiences I had was when Mrs. Holliday came to visit. I was able to present my case for her and the rest of the clinical dietitians which was a good public speaking exercise. I was also able to get some feedback and ideas for my paper.

Afterward, the patient that we worked up together was a terminal cancer patient - a man in his fifties. While we looked at his chart, it became apparent that he was probably in his last weeks of life (his white count was 0.7), yet his doctor had him on a cardiac diet. Mrs. Holliday asked me what my opinion was about our role as dietitians in end-of-life care. Now, I have worked up several patients this summer who were in a similar condition as this man, but I realized that this was not something I had thought about in depth. We talked about how when people die it is basically a slow process of malnourishment which eventually leads to the shutting down of organ systems and then death. She explained to me that often, the medical team will stop hydrating terminal patients because at a certain point dehydration leads to a euphoric state for that person.

I ended up going into talk to the patient's wife (he minimally responsive) and told her that they should feel free to make any food requests. I didn't see any reason to put restrictions on a patient in his condition and did my best to be more compassionate toward her than anything. This case definitely gave me some things to think about... what is our role in the care of terminal patients? Shouldn't they be given whatever food they want on the off chance that they actually feel like eating? What would I want for myself or one of my own family members? All important things to consider...