One of the most
comprehensive guidelines I have seen is taken from the Dietitians
Association of Australia position paper. What do you think about this?
Issues of importance in deciding dietary management priorities include:
1. Patient prognosis. Ongoing reassessment of the patient's
medical status is essential to ensure that dietary management is
appropriate to the patient's prognosis and medical treatment.
2. Ethical considerations. This include
respecting a patient's decision, balancing the benefits and
burdens of particular treatment options, and reviewing resources
available.
3. Patient autonomy. The patient's
informed preference for the type of nutrition support is of utmost
importance.
4. Benefits versus burdens of nutritional
support. The expected benefits in contrast to the potential
burdens of the method of feeding should be evaluated and discussed
with the patient. The dietitian must ask herself if aggressive
nutritional support will improve the patient's quality of life
during the final stages of morbidity.
5. Available resources. Practical and
economic considerations should be reviewed.
6. Therapeutic diets. The rationale for
previous dietary restrictions require ongoing reassessment. The
restriction should be liberalized or minimized where possible.
Long term complication are generally not of concern in the dying
patient.
7. Patient comfort. Control of symptoms
related to eating and digestion are important to maximize the
patient's comfort.
8. Food attitudes. Food is more than a
substance which sustains health and enable growth. It is also a
means of communication, a common bond between people of all ages
and all races, and a source of pleasure.
9. Social aspects. Eating is an important
social process extending far beyond its nutritional support.
Family interaction and socialization at mealtimes should be
encouraged as a social function.
10. Food selection. Patients with cancer
often experience a loss of appetite. This may include changes in
the palatability of of foods and food aversion. To provide
individual food preferences require flexibility and imagination.
Efforts should be made at alleviating
symptoms that may have a negative impact on food intake. Examples
of such symptoms are pain, nausea, vomiting, insomnia and anxiety.
If you have questions related to this article you may e-mail me
at doctor@soontongkiong.com quoting the contents of the article.
About the author
DR SOON is a medical practitioner. He holds four degrees. MBBS
(University of Malaya), MBA (University of East Asia), LLB (Hons)
(University of Wolverhampton), Master of Medicine (Edith Cowan
University
:
Dr SOON is the owner of AskMyVisitor.com and MyScriptDoctor.com
where you can find the most up-to-date advice and information
on
many medical, health and lifestyle topics.
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