Deciding About Artificial Hydration

When you have a serious illness, your healthcare provider will review treatment options with you as your illness progresses. Some of these treatments help support or sustain life if your body can no longer perform certain functions on its own.

Artificial hydration is one such treatment. It supplies fluids to your body if you can no longer take in fluids by mouth. This sheet tells you more about artificial hydration and what you need to know when deciding about this treatment.

How is artificial hydration given?

Artificial hydration is given using a thin tube called an intravenous (IV) line. To insert the line, a small needle is put through the skin into a vein. This is most often in the arm or hand. Fluids are then sent through the line into the body.

What are the risks of artificial hydration?

Risks include bleeding and infection at the IV site. Also, too much fluid can build up in the body. This can cause uncomfortable swelling in the arms, legs and belly. Fluid can also build up in the lungs, which can cause trouble breathing and shortness of breath.

What happens if I choose to have artificial hydration?

You will continue to receive fluids to help your body function. This may increase comfort and improve quality of life for some time. If you are near the end of your life, you may find it hard to tolerate the problems that can occur with this treatment. In this case, your healthcare provider may recommend against artificial hydration if it is too much of a burden on your body, or if it will not prolong life or provide comfort.

What happens if I choose not to have artificial hydration?

If you choose not to have this treatment, you will continue to receive comfort care. This involves measures to relieve pain and other symptoms. Without fluids, the body will slowly shut down, and death will occur within a few days or weeks.

You may find it reassuring to know that dehydration is a natural part of the dying process. Studies show that most patients near the end of life do not typically feel thirst. Dry mouth is a more common problem, which can be relieved by keeping the lips and mouth moist. Ice chips and small sips of water can also be given if desired.

In the last days of life, dehydration may help trigger the release of chemicals in the brain that can leave you with a sense of calm and well-being. This may help you pass your final hours in greater comfort.

How do I decide if I want artificial hydration?

Your healthcare provider and other members of your healthcare team can tell you more about artificial hydration and what it means for you. If you want, you may include family and friends in these discussions. As you make your decision, here are some things to think about or ask your healthcare team:

• Will my illness improve or will it worsen? How likely is a cure?
• How will artificial hydration affect my health? Will having the treatment change the outcome of my illness?
• What are the risks and benefits of artificial hydration? What problems can it cause? How will artificial hydration affect my comfort and quality of life?

How do I state my decision about artificial hydration?

You can make your decision known by telling your healthcare provider directly. It is best to also put your treatment wishes in writing in the NYS health care proxy form and the Medical Orders for Life Sustaining Treatment form (MOLST). Ask your healthcare team about these forms and about what is most appropriate for your situation.

Keep in mind that you can change or cancel an advance directive at any time. Make it a practice to review your decisions each time there is a change in your health or goals of care. Also, be sure to tell your healthcare agent and loved ones of any changes in your decisions.