Considerations for Alternate Nutrition and Hydration: Educating Staff and Family

Course Description:

When making recommendations for patients, we may have to consider alternate forms of nutrition and hydration based on their unique set of circumstances. One consideration is how long ANH may be necessary – short term vs. long term. Research has looked at benefits and burdens and trajectory of diseases – COVID-19, CVA, cancer, dementia, EOL to name a few. COVID-19 patients may require short term ANH due to intubation or inability to meet their nutritional needs by mouth or GI issues. Because a patient’s status changes quickly with COVID-19, the individual may not have any advance directives addressing ANH. Individuals who have had mechanical ventilation may experience post-extubation dysphagia. Although we have the ability to provide ANH, the question moves from can we to should we! Patients and families religious and cultural beliefs influence their decision making and sometimes clash those of their health care professional. What options are there for patients and families who don’t accept that recommendation? Waivers are not the answer, but EDAR (eating and drinking with acknowledged risk) or Care Planning for Resident Choice are possibilities.