In terminally ill patients, what is a key consideration regarding enteral feeding?

• A. EN always ensures comfort
• B. Hydration should be maintained to all patients
• C. Enteral feeding and hydration do not always ensure comfort; small amounts can prevent ketosis and prolong hunger
• D. EN should be avoided entirely

Answer: (C)

In end-of-life care, the aim is comfort and alignment with the patient’s goals, not simply more calories. Enteral feeding and hydration do not automatically improve comfort, and starting or continuing them can introduce burdens such as risk of aspiration, fullness, diarrhea, or fluid overload. Providing small amounts of nutrition or fluids can help prevent ketosis from prolonged inadequate intake and may modestly ease hunger without committing to full feeding. This approach supports comfort and patient-centered decision-making, rather than assuming that feeding is always beneficial.