Clin Nutr Res.  2018 Apr;7(2):146-152. 10.7762/cnr.2018.7.2.146.

Nutrition Intervention through Interdisciplinary Medical Treatment in Hospice Patients: From Admission to Death

• Kang H
• Yang YJ
• Park J
• Heo GJ
• Hong JI
• Kim HJ

• KMID: 2409993
• DOI: http://doi.org/10.7762/cnr.2018.7.2.146

Abstract

The demand for hospice services as well as for "˜well-dying' of terminal patients is increasing as patient financial burden is decreasing due to National Health Insurance coverage for hospice care. Hospice institutions utilize interdisciplinary teams comprising doctors, nurses, dietitians, and other health staffs to provide comprehensive patient management. This report examined the nutritional status of a hospice patient from admission to death as well as the nutrition management of this patient in the hospice ward through nutrition interventions performed by a dietitian in the interdisciplinary team. The patient in the present case was a 74-year-old man diagnosed with pancreatic head cancer who died after 26 days of hospice care following transfer from the general ward. During hospice care, the dietitian monitored the patient's nutritional status and performed 8 nutrition interventions, but his oral intake decreased as the patient's symptoms worsened. The average energy intake rates were 30% and 17% of required rates for oral and artificial nutrition, respectively. In line with a report suggesting that the main focus of nutrition in palliative care should be on improving the quality of life and reducing worry in patients, rather than aggressive nutritional management, there is a need for nutrition interventions that are personalized to individual patients by monitoring progress and offering continuous counseling from the time of admission. In addition, further studies such as comparative analysis of nutritional management in Korean hospice ward will be needed for better nutrition management for terminally ill patients.

Keyword

Hospice care; Nutrition intervention; Artificial nutrition; Interdisciplinary team

MeSH Terms

Aged
Counseling
Energy Intake
Head and Neck Neoplasms
Hospice Care
Hospices*
Humans
National Health Programs
Nutritional Status
Nutritionists
Palliative Care
Patients' Rooms
Quality of Life
Terminally Ill

Figure

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  Figure 1 Changes in energy intake through oral and AN.AN, artificial nutrition.*Percentage (%) indicated ratio of total energy intake to required energy intake.

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