Nutrition support (commonly referred to as tube feeding or total parenteral nutrition, TPN) can be provided when an individual cannot safely access enough calories and nutrients through oral intake alone. TPN may be administered using an intravenous tube placed into their stomach or small intestine or given via vein.
Studies indicate that without proper nutrition support teams in place, patients could experience additional complications and therapy that is unnecessary for treatment.
End-of-Life Care
End-of-life care involves providing patients with physical and emotional assistance so they can pass peacefully, including hospice services which may be offered in hospitals, at home, or nursing homes.
As one naturally dies, their body begins to shut down and no longer requires energy for digestion of food and beverages. According to studies, terminally ill patients who opt to stop eating and drinking typically don’t experience hunger or thirst and may find greater comfort and relaxation without these processes.
As end of life approaches, some patients become disoriented and struggle to recognize time, place or people. Playing familiar music, displaying personal mementos and talking about their past can all help; open and honest communication between family members and healthcare providers may also prove useful in understanding each patient’s wishes and communicating them early in diagnosis and treatment processes if possible.
Critical Illness
Being diagnosed with a serious illness can put undue financial strain on families. Even with medical insurance coverage in place, travel costs and additional expenses may still add up quickly. Critical illness coverage (also called critical care insurance) provides some protection from these unexpected costs so you can focus on healing yourself rather than covering unexpected costs.
Although artificial nutrition options for critically ill patients have grown more widespread over the past decades, few rigorous randomised controlled trials (RCTs) have conducted studies assessing their impact on morbidity and mortality rates. Furthermore, due to gastrointestinal dysfunction and unstable electrolyte and fluid balances, it can be challenging estimating energy requirements of these patients accurately; blinding patients within clinical units would not be practical due to route and dose restrictions on feedings.
Palliative Care
Palliative care can often be misinterpreted. Its definition can vary widely, from primary care physicians and specialists like oncology or heart doctors, home health agencies and hospices all the way to private companies offering this form of support – and its appearance varies greatly between patients.
Nutritional support can assist patients in managing physical, emotional, social and spiritual stresses associated with serious illness. This may include assessing and controlling poorly-controlled symptoms; helping people understand their illness’s expected trajectory and treatment options; exploring hopes, concerns, goals and values; as well as supporting families in care giving roles.
Emotional support services may also help meet other emotional and psychological needs, including fears, anxiety, hopelessness and depression. Treatment may involve identifying food or drink preferences that cause distress such as dysphagia. Finally, these services may discuss and document end-of-life wishes such as medical interventions they want or don’t want; these should be documented on an advanced directive or MOLST form.
Surgery
Undergoing surgery puts patients at greater risk for nutritional depletion due to stress and changes in metabolism. Receiving nutritional support during and after recovery can improve recovery and shorten hospital stays, speeding recovery time.
Nutritional support should be delivered through an all-encompassing plan that encompasses preoperative nutritional counseling and optimization, shortening fasting time, early postoperative feeding integration, reasonable fluid management practices and post-discharge diet management.
Studies comparing nutrition support to standard care have demonstrated its efficacy at decreasing pressure ulcers in nursing practice, redness and swelling, edema scores and anxiety scores, bleeding volumes, recovery times and incidence rates of pressure ulcers.
People requiring enteral tube feeding or parenteral nutrition should receive nutritional support beginning the first day after surgery. Initial dosing should begin at no more than 50% of estimated energy and protein requirements and gradually increased according to clinical and biochemical tolerance, including adequate fluids, electrolytes and vitamins.
