Advance Care Planning: Do I Want Fluids or Tube Feedings?

Making health decisions is part of life. These decisions can have a big effect on your health and happiness. Some decisions may affect how good your health care is. Others may affect how much it costs. Most people feel better about their health care when they take part in these decisions.

Making your wishes known ahead of time is especially important if you have a terminal illness. There may come a time when you can't speak for yourself. If that happens, your doctor and your family will know what kind of care you want.

This information will help you understand your choices. Your decision should be based on the medical facts as well as your own feelings. Talk to your doctor and loved ones about your wishes.

Your choices

  • You can use artificial means if needed to keep yourself alive. It will not cure your illness. In some cases it causes discomfort.
  • You can decide not to use artificial means to keep yourself alive. Your body will slow down naturally, and you will be kept comfortable until you die.

Key points in making your decision

  • Artificial feeding and hydration gives you nutrition and liquids when you can't eat or drink.
    • A feeding tube can be either a tube placed in the stomach through the nose or surgically inserted through the belly into the stomach. The tube supplies medicines, fluids, and nutrition.
    • An intravenous (I.V.) line is a needle that is put in your vein through which fluids, liquid nutrition, and medicines can be given. Sometimes fluids are injected directly under your skin.
  • Some people feel better with this treatment as they near the end of life. The treatment gives them more energy than they would have without food and water.
  • This treatment makes some people uncomfortable. A feeding tube can irritate the skin and the stomach lining. The liquids received through I.V.s or feeding tubes can cause swelling in the arms and legs, fluid in the lungs, a swollen stomach, diarrhea, or nausea.
  • Whether you have artificial feeding or not, your doctor will take steps to help you feel comfortable.

Think about the facts and about what matters most to you. To help with your decision, take this information to your doctor and talk with him or her about your thoughts and feelings. Ask for more information if needed.

Reasons to have I.V.s and tube feedings Reasons not to have I.V.s and tube feedings
  • Artificial feeding can help you recover from a short illness or injury.
  • You feel that artificial feeding can help improve the quality of your remaining time.
  • You believe that every possible step should be taken to preserve life, regardless of quality of life.
  • There is hope that there is or will soon be a cure for your condition.
  • This treatment cannot cure a terminal illness.
  • The benefits are outweighed by the risks, including infection, pneumonia, and digestive problems.
  • You do not wish to be kept alive by artificial means.
  • The I.V., tube, or fluids may cause more discomfort than not having them.
Circle the answers that best apply to you.
I want to have artificial feeding if I am no longer able to take fluids or food by mouth. Yes No Unsure
Artificial feeding may give me the chance to meet the goals I have for the time I have left. Yes No Unsure
The possible benefits of artificial feeding do not outweigh the risks. Yes No Unsure
Artificial feeding offers a reasonable chance of improving my comfort. Yes No Unsure
I feel I can communicate openly and clearly with my loved ones and my health care workers. Yes No Unsure