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    Care at the End of Life - Important Decisions

    Artificial hydration and nutrition

    Another important treatment issue to consider is whether you want intravenous, or IV, lines or feeding tubes to be used if you are no longer able to take food or fluids by mouth. This is known as artificial hydration and nutrition. An IV is a needle placed in your vein through which fluids, liquid nutritional supplements, or medicines can be given. A feeding tube can be either a tube inserted into the stomach through the nose (nasogastric, or NG, tube) or a tube surgically inserted through the abdomen into the stomach (gastrostomy or PEG tube, or g-tube). As with an IV line, liquid nutritional supplements, fluids, or medicines can be given through a feeding tube. A third form of artificial hydration, hypodermoclysis, involves the injection of fluids directly into tissues beneath the skin (subcutaneous).

    Changes in your body in the final weeks of life reduce your need for food and water. You will likely not be thirsty or hungry. You may feel better without artificial hydration or nutrition.

    Talk to your doctor if you are considering artificial hydration and nutrition. Making a plan for IV fluids and feeding tubes early in the course of your illness may be helpful if you are faced later on with the decision to pursue or forgo these treatments. Remember to communicate your wishes clearly with your family and your doctor.

    For more information on this decision, see:

    Should I Have Artificial Hydration and Nutrition?

    Kidney dialysis

    Deciding when to stop kidney dialysis can be a difficult decision for people who have kidney failure. A person with kidney failure needs dialysis or a kidney transplant to sustain life. Kidney failure often occurs after kidney damage has been present for 10 years or more. It usually is caused by a chronic disease, such as chronic renal disease or diabetes, that slowly damages the kidneys and reduces their function over time.

    Although dialysis sustains life, it is not a cure for kidney failure. Having kidney disease means making difficult choices. Many people with kidney failure live active, productive lives while having regular dialysis treatment. But others do not feel as healthy and struggle with the complications of dialysis.

    For more information on this decision, see:

    Should I Stop Kidney Dialysis?
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