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Palliative care - fluid, food, and digestion

Constipation - palliative care; End of life - digestion; Hospice - digestion

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Description

People who have a very serious illness or who are dying often don't feel like eating. Body systems that manage fluids and food may change at this time. They can slow and fail. Also, some medicines that treat pain can cause dry, hard stools that are difficult to pass.

Palliative Care

Palliative care is a holistic approach to care that focuses on treating pain and symptoms and improving quality of life in people with serious illnesses and a limited life span.

When Your Body has Problems Handling Fluids and Food

A person who is very sick or dying may experience:

• Loss of appetite
• Trouble chewing, caused by mouth or tooth pain, mouth sores, or a stiff or painful jaw
• Constipation, which is fewer bowel movements than usual or hard stools
• Nausea or vomiting

What you can do to Feel Better

These tips may help relieve discomfort due to loss of appetite or problems eating and drinking.

Fluids:

• Sip water at least every 2 hours while awake.
• Fluids can be given by mouth, through a feeding tube, through a tube that goes into a vein (intravenous; IV), or through a needle that goes under the skin (subcutaneous).
• Keep the mouth moist with ice chips, a sponge, or oral swabs made for this purpose.
• Talk to someone on the health care team about what happens if there is too much or too little fluid in the body. Decide together whether the person needs more fluids than they are taking in.

Food:

• Cut food into small pieces.
• Blend or mash foods so they don't need to be chewed much.
• Offer food that is soft and smooth, like soup, yogurt, applesauce, or pudding.
• Offer shakes or smoothies.
• For nausea, try dry, salty foods and clear liquids.

Digestion:

• If needed, write down the times the person has bowel movements.
• Sip water or juice at least every 2 hours while awake.
• Eat fruit, such as prunes.
• If possible, walk more.
• Talk to someone on the health care team about stool softeners or laxatives.

When to Call the Doctor

Contact a member of the health care team if nausea, constipation, or pain cannot be managed.

References

Arnold RM, Kutner JS. Palliative care. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 3.

Nabati L, Abrahm JL. Caring for patients at the end of life. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 51.

Shah AC, Cobert J, Gebauer S. Palliative medicine. In: Gropper MA, Cohen NH, Eriksson LI, Fleisher LA, Johnson-Akeju S, Leslie K, eds, Miller's Anesthesia. 10th ed. Philadelphia, PA: Elsevier; 2025:chap 48.

Shreves A, Quest TE. End of life. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap e5.

Review Date: 1/14/2026  

Reviewed By: Linda J. Vorvick, MD, Clinical Professor Emeritus, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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