Food or Medicine
Culture and ethnicity shape patient’s and families’ view about artificial hydration (AH) at the end of life, with ethnic minorities seeing it as food more often than non-Hispanic European Americans, according to 2012 research.
“Identifying some of the beliefs and barriers regarding the decision-making process in this challenging area may provide preliminary evidence for culturally appropriate end-of-life communication strategies and care that incorporates individual assessments of the pros and cons of hydrating in each particular context,” suggest Isabel Torres-Vigil of the University of Houston, Texas, and co-investigators.
They conducted an interview-based study of 122 terminally ill cancer patients, asking, “Are these fluids more like food or more like medicine?” The study authors sorted answers as food, medicine, both or other.
Results showed 38% saw AH like food, 34% as medicine, 14% as both, and 14% as other (including vitamins and saline). Ethnic minorities perceived the AH as food 66% of the time vs. 41% for non-Hispanic European Americans.
The findings were significant enough that the research team suggest when patients with advanced cancer begin to decrease their oral intake of fluids, healthcare professionals should ask what perceptions they or their caregivers have about the role of AH to promote the most patient-oriented approach to end-of-life care.
Source: British Medical Journal: Supportive and Palliative Care, July 2012.
This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 26. To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.