Do enteral feeding and hydration ensure comfort in the end of life?

• A. Yes
• B. No
• C. Sometimes
• D. Not sure

Answer: (B)

In end-of-life care, comfort comes from relieving symptoms, not from sustaining nutrition or fluids. Artificial enteral feeding and hydration do not reliably improve comfort and can introduce new burdens. Tube feeds can cause abdominal fullness, bloating, nausea, vomiting, diarrhea or constipation, and may worsen edema. Hydration, when given intravenously or via a tube, can increase secretions, coughing, and the risk of aspiration, and it may even prolong the dying process without making the person feel more comfortable. As death approaches, many patients naturally drink and eat less, and forcing intake can feel burdensome rather than soothing. The focus then shifts to comfort measures like oral care for dryness, humidified air, pain and symptom control, and limiting interventions that don’t alleviate distress. If a patient or family expresses a specific desire for hydration or nutrition to relieve symptoms, these decisions should be guided by goals of care and careful assessment, but they are not guarantees of comfort.