Acreman Sue
Cancer Rehabilitation, Velindre, NHS Trust.
Br J Community Nurs. 2009 Oct;14(10):427-8, 430-1. doi: 10.12968/bjcn.2009.14.10.44494.
Nutrition in palliative care and at the end of life should be one of the goals for improving quality of life. It is important to address issues of food and feeding at this time to assist in the management of troublesome symptoms as well as to enhance the remaining life. While this paper focuses upon the nutritional aspects of cancer in palliative care, the sentiments are applicable to other serious chronic illnesses such as advanced cardiac failure, chronic obstructive pulmonary disease and dementia. Cancer and its treatments exert a major impact upon physical and psychological reserves and at the end of life problems with appetite and the ability to eat and drink compound such impact. The aims of nutritional care minimize food-related discomfort and maximize food enjoyment. Identification of any nutritional problems can facilitate the employment of strategies which need to be discussed with the patient and their families and reviewed regularly as conditions change. Ethical questions will be raised concerning the provision of food and fluids to a person nearing the end of their life. Nurses need to acknowledge that food has greater significance than the provision of nutrients.
姑息治疗及生命终末期的营养应成为改善生活质量的目标之一。此时解决饮食问题很重要，有助于处理棘手症状并提升剩余生命质量。尽管本文聚焦于姑息治疗中癌症的营养方面，但这些观点也适用于其他严重慢性疾病，如晚期心力衰竭、慢性阻塞性肺疾病和痴呆症。癌症及其治疗对身体和心理储备有重大影响，在生命终末期，食欲及吃喝能力的问题会使这种影响更为复杂。营养护理的目标是将与食物相关的不适降至最低，并最大化食物带来的愉悦感。识别任何营养问题有助于采取相应策略，这些策略需要与患者及其家属讨论，并随着病情变化定期评估。关于为临终患者提供食物和液体，会引发伦理问题。护士需要认识到，食物的意义远不止于提供营养。
