When a Little May Be Just Enough? Caring for People With Swallowing Difficulties at the End of Life, and Their Caregivers Nutrition and hydration are emotive topics in many fields of health care. This can present particular challenges towards the end of life where reduced hydration and nutritional needs are a natural part of dying. Speech-language pathologists (SLPs) are increasingly involved in the care of dying patients. It is essential that ... Article
Article  |   June 14, 2016
When a Little May Be Just Enough? Caring for People With Swallowing Difficulties at the End of Life, and Their Caregivers
Author Affiliations & Notes
  • Justin Roe
    The Royal Marsden NHS Foundation Trust, London, UK
    Imperial Healthcare NHS Trust, London, UK
    Imperial College London, London, UK
  • Rob George
    St Christopher’s Hospice, London, UK
    Cicely Saunders Institute, Kings College, London, UK
    Guy's and St Thomas' NHS Foundation Trust, London, UK
  • Disclosures
    Disclosures ×
  • Financial: The authors have no relevant financial interests to disclose.
    Financial: The authors have no relevant financial interests to disclose.×
  • Nonfinancial: The authors have no relevant nonfinancial interests to disclose.
    Nonfinancial: The authors have no relevant nonfinancial interests to disclose.×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Part 2
Article   |   June 14, 2016
When a Little May Be Just Enough? Caring for People With Swallowing Difficulties at the End of Life, and Their Caregivers
Perspectives of the ASHA Special Interest Groups, June 2016, Vol. 1, 89-93. doi:10.1044/persp1.SIG13.89
History: Received November 19, 2015 , Revised February 19, 2016 , Accepted February 24, 2016
Perspectives of the ASHA Special Interest Groups, June 2016, Vol. 1, 89-93. doi:10.1044/persp1.SIG13.89
History: Received November 19, 2015; Revised February 19, 2016; Accepted February 24, 2016

Nutrition and hydration are emotive topics in many fields of health care. This can present particular challenges towards the end of life where reduced hydration and nutritional needs are a natural part of dying. Speech-language pathologists (SLPs) are increasingly involved in the care of dying patients. It is essential that they work as part of a dedicated, multidisciplinary team delivering a comprehensive package of specialist palliative care. In this paper, we will review the role of the SLP at the end of life and present information that will support the SLP to recognise and understand dying, and how medical and SLP interventions may compound rather than relieve symptoms. It is paramount that interventions are ethically sound and decision making is shared, respecting the autonomy of patients. In the event patients lack capacity, any advance directives/decisions and statements should be considered in consultation with caregivers. At the end of life, the focus of our intervention may shift from the patient to the caregiver, ensuring that they have a meaningful role in the care of their loved one in the final stages of dying.

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