Thread by @kimacquaviva

👇🏼Thread

It’s been ~48 hours since Kathy last expressed a desire for ice chips or water.

Once I stopped giving her dexamethasone, her thirst stopped.

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She’d been taking the dexamethasone for referred pain (pain in her shoulder and back) caused by the liver metastasis. Stopping the dexamethasone doesn’t appear to have increased her discomfort any.

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It’s been about a week since @Kathy_Brandt last asked for food.

I haven’t offered any to her after that.

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Hospice and palliative care folks know what I’m about to say but for followers who aren’t #hapc #hpm professionals, I thought it might be helpful info to share.

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When someone’s dying, their body stops wanting food and water. This is basically one of the body’s built-in mechanisms to ensure comfort at the end of life.

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Think of the human body like a car. When you drive your car a lot, you need to keep putting gas in the tank. If your car is just sitting in the garage, though, topping off the tank every day isn’t helpful - gas spills all over the ground.

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When someone is dying, their organs stop sending “gas me up” messages to the brain. Reduced hunger and thirst is the body’s way of saying, “we have plenty of gas to make the trip in front of us.”

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This can be hard for family members to deal with. Food and water are the things that keep us alive. Food is one of the ways we show love to one another. It’s one of the ways we nurture people we love.

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This is why it’s so important to explain to families — in terms a layperson can understand — that it’s an act of love when they listen to what their loved one’s body is telling them.

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Just like gas spills out onto the floor if you try to top off a full tank, feeding and hydrating a dying person who’s no longer hungry or thirsty may cause a cascade of discomfort.

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If the dying person’s body can’t use the food or fluids being put into it, the tank sort of overflows. Fluid can build up making breathing uncomfortable.

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The digestive system of a dying person is basically like a diner 2 minutes before closing time. Anything coming in the door at the last minute is unlikely to get great customer service.

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This isn’t the most medically precise explanation of how the human body shuts down near death but it should give you the basic idea.

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So if you’re ever with a dying person who stops asking for food or water, pause a moment and remind yourself that their body is doing its best to die peacefully.

Pushing food and water may prevent their body from doing that important job successfully.

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If you’re reading this and feeling guilty about pushing food or water with a dying loved one in the past, please don’t.

We all do the best we can with the information we have in the moment we’re living.

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Thanks for listening. ♥️

/end thread