How the district nurse cares for the terminally ill patient with cachexia.

The aims of this study were to establish how district nurses cared for terminally ill patients with cachexia at home; to establish the priorities in the care given; and to establish the nurses' understanding of the core activities undertaken. The study allowed the views of district nurses to be examined in the context of their understanding of the care they gave. A literature review revealed that the metabolic disorders associated with cachexia mean that the condition is not simply the result of insufficient food intake. However, data from the study suggest that some district nurses have little understanding of the metabolic disorders associated with cachexia and revealed that care centres around advising and encouraging the cachectic patient to increase his/her food intake; such advice and encouragement were seen as the core activities in caring for the cachectic patient at home. This small study of 10 district nurse suggests that cachectic patients are put under unnecessary pressure to eat by both the formal and informal carer, and that as a result the patient may feel unsupported by the carers' lack of knowledge about his/her condition.