ABSTRACT
This chapter contains clinical decision and action checklist for managing a patient with nutrition and hydration problem. In patients who are comatose and comfortable, dehydration causes few symptoms, but dehydration can cause or contribute to an agitated confusional state in some patients. Family, friends or staff may feel a need to continue hydration or feeding and they will need explanation and support. The relatives or parents persist with the request for hydration or feeding in a dying adult or child, even though the patient is comfortable. Non-oral hydration is most conveniently given subcutaneously. Unlike the intravenous route, subcutaneous cannulae can be left in place for 7–10 days without problems. Anorexia is helpful to support the patient to adapt to the reduced intake to reduce their fear, and reassure the partner and family it is not their failure to care. In many patients, the anorexia is part of the advanced illness and is more of a concern to carers.
