The Last Days of Life
Most people stop eating and drinking in the last days of life. These changes are part of the dying process and are not usually associated with hunger or thirst.
- Unnecessary suffering: The person is given food or drink they don’t want or cannot safely swallow.
- Disregarded wishes: The person’s decision-making capacity isn’t recognised, and they are fed or hydrated against their will
- Lack of awareness: The person may not know they can refuse food or drink and feel pressured to eat or drink when they don’t want to.
- Check if the person has an Advance Care Directive or other planning documents outlining their decisions about nutrition and hydration.
- Ensure these documents and recorded decisions are accessible to all care staff to guide care delivery.
- Educate staff and families about the natural dying process, help them understand that refusing food and drink is a normal and expected part of this stage.
- Reflect on staff and family understanding of nutrition and hydration during the dying process.
- Regularly check in with the person (or their decision-maker) to ensure they have the information they need and feel their wishes are respected.
A person should be offered food and drink for as long as they want it and can safely have it. However, it is common for people in their final days to lose interest in eating and drinking and to stop altogether.
If a person can make their own decisions, they have the legal right to refuse food, drinks, or artificial nutrition and hydration—even if this means they will die sooner. Their choice should be respected.
Some people may have written instructions in an Advance Care Plan (e.g. Advance Care Directive) about whether they want food and drink (including artificial feeding) to be given or stopped. If the directive is valid, it must be followed when the person can no longer make decisions. Laws about Advance Care Directives and stopping artificial nutrition and hydration can be different in each state and territory. For the most up-to-date information, visit the ELDAC End of Life Law Toolkit.
If a person stops eating and drinking, medicines can help reduce pain or other symptoms. Keeping their mouth moist—such as offering ice to suck on, using swabs to wet their lips, or applying lip balm - may also help keep them comfortable.
Health professions can witthold futile or non-beneficial supports
A person should be offered food and drink for as long as they want it and can safely have it. However, it is common for people in their final days to lose interest in eating and drinking and to stop altogether.
Health professionals can decide not to start or continue artificial nutrition or hydration if it will not help the person or improve their quality of life. While formal consent is usually not needed, it is best practice for health professionals to talk with the person (if they can make their own decisions) or their substitute decision-maker (if they cannot). This helps ensure everyone understands the care being given.