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Decision- making about artificial feeding in end- of- life care literature review

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Metrics details. A growing body of evidence focuses on symptom management at the end-of-life, but research funding for palliative care remains disproportionately low. It is therefore crucial that research funding is targeted at areas of importance to patients and relatives. The Palliative and end-of-life care Priority Setting Partnership PeolcPSP undertook a UK-wide free-text survey to establish research priorities within palliative and end-of-life care and disseminated its results in
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Approaches to Eating and Drinking with Acknowledged Risk: A Systematic Review

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Nutrition Support at the End of Life: A Critical Decision

Background: Nutritional problems often manifest during late-stage dementia, and some families may request to instigate artificial nutrition and hydration ANH therapies. In the US, an estimated one-third of nursing home patients with a severe cognitive impairment have artificial feeding tubes inserted. Fear that a relative could experience extreme hunger or thirst if they are not mechanically fed tends to be the main driver behind family's requests to implement artificial or enteral feeding methods. In contrast, artificial hydration is rarely given to older people with dementia in the UK and this practice of non-intervention tends to apply across all healthcare and hospice type environments. Aim: This literature review aims to evaluate the evidence to support the use and non-use of ANH.
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Decision-making about artificial feeding in end-of-life care: literature review

There has been increase in awareness of end-of-life and palliative care issues in recent years for the general public, as well as for people with intellectual and developmental disabilities IDD. Despite these changes, clinical experience, public attitudes, medical practice, and legal opinion concerning caring at the end of life vary significantly across the United States. It is important that appropriate and accurate information be available to support sound decision-making. Evidence exists to indicate that people with IDD are particularly at risk when caregivers do not have clear, consistent, and ethically sound guidelines.
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Metrics details. Some people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions are disrupted.
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