Being a Palliative Medicine NP, I've read through these stories of hospice and losing a loved one. First off, I'd like to say my condolences are with you all that have lost a loved one. I know how deeply hard it is to watch some one you love pass on. For that, you have my sympathies.
I've been asked a lot "why no IV hydration?" Good question and one I wrestled with in the beginning of my career. Seems cruel, yes. But I like to explain it simply to families.
Imagine you've had a long day at work. You've had no time to eat or drink. You begin to get cranky. You're back hurts. Your nauseous. You get a headache. You're irritated. Your brain feels foggy. You get home and want to eat and sometimes that food hits your stomach, you may get a little nauseous. You drink a cold glass of water and your stomach gets a little upset. Technically, if you've been through this then you've experienced the very beginning of the dehydration process. And yes, it's not pleasant.
If this persisted, and you continued to not eat or drink, you're body releases its own natural endorphins to provide analgesia. Thirst subsides. Hunger subsides. Nausea subsides. Pain subsides. Euphoria begins to aid your body in dealing with the situation. The person sleeps more, breathing slows. Heart rate decreases. It's now more comfortable to be dehydrated. If we reintroduce fluids-the whole process begins again. Pain, nausea, confusion, increase in anxiety. Endorphins subside....natural analgesia is suppressed.
It is not that hospice wants to prolong suffering. Our culture feels eating and drinking is living. And yes, for a healthy, or not terminal person, it sustains life. But for a person that is dying, it hurts them worse. We call it dry death because indeed, without fluids the patient will die. But if we introduce fluids again, we have extended and worsened the death process.
Not all hospices are the same. My advice....ask for references to good hospice associations. Usually the larger, the better as they see more clients, invest more In staff and train them more frequently and have more experience with the dying process. That's not to say smaller organizations don't provide excellent care. Some do....you just have to do some research and listen to good word of mouth.