How to educate patients and caregivers on end-of-life nutrition care and support.

Abstract

Background: There are numerous articles, book chapters, and published guidelines on the topic of clinical ethics in the use of artificially administered nutrition and hydration, which often incorporates end-of-life (EOL) nutrition care and support. Components of clinical ethics involve the importance of ethical principles, patient-centered care, and shared decision-making. However, there is sparse information on how to educate patients and caregivers on this subject.

Methods: Initially, PubMed and the Cochrane Library were used to find articles on the subject. Articles were reviewed and new concepts were identified to include.

Results: There is a practice gap with not applying clinical ethics in practice. The application of clinical ethics, which includes the teach-back method of education, soft skills and behavioral skills training, and potential sacred moments, is not well addressed in the literature. Demonstration of the process of incorporating clinical ethics into practice is beneficial in helping educate clinicians so they can then effectively educate the patient and caregiver on EOL nutrition care and support. Reasons for not applying clinical ethics in actual clinical practice may be because of clinicians not receiving training, the lack of opportunity to observe the technique applied in actual clinical practice, or possibly concern for the presumed additional time required in clinical practice to apply clinical ethics.

Conclusion: Educating patients and caregivers on EOL nutrition care and support presupposes engaging, educating, and empowering clinicians about clinical ethics by demonstrating the process and encouraging educators to incorporate the information in an interdisciplinary/interprofessional curriculum.