I'm Catholic and recently did some reading on the subject of refusing artificial nutrition and hydration. From what I understand the position of the Catholic theologians is that artificial nutrition and hydration are considered ordinary care and thus must be used, as long as the body is able to derive benefit from them. So a person whose body had not begun to shut down organs would have to use artificial means morally speaking.
Am I correct in assuming that hospice does not use feeding tubes, etc. for nutrition/hydration? Is palliative care the best alternative if you are following Catholic teaching re artificial food/hydration?
Was thinking about end of life directives and it seems that using hospice would not work if, as a Catholic, I could not refuse artificial nutrition/hydration.

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My mother was in a SNF when she died and was not placed on hospice until she’d refused food for several days.

She was cared for by some active, practicing Catholic RNs.

She was not hospitalized and no products were offered by mouth at any time.

My present LO, currently under hospice, is receiving similar care. She still eats (with relish!) drinks, and coughs.

No violations of her Roman Catholic Faith will be permitted when she comes to her natural end of life.

Many priests are well trained in both Comfort to the Dying, and Comfort to those who care for them. Be sure to consult a priest if you continue to be concerned about this.
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My father was in a Catholic hospice. They did not force a feeding tube, they did give him IV fluids, it was helpful when administering pain control and other meds as he had difficulty swallowing. They were kind and efficient.
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I am Catholic. Our church held a wonderful ‘end of life’ seminar which we attended.

The priest who led the seminar was fabulous! He had his philosophy degree as well as his theology degree. He went on to get a psych degree, became a psychiatrist and the hospital chaplain. So, obviously he was a well educated, well rounded, well respected man.

He was a straight shooter, he was originally from New York, moved to Chicago and finally ended up here in New Orleans. He discussed this topic at length. The Catholic Church absolutely does not expect or insist that anyone use any feeding tubes or any other care to prolong a life!

Thank you for asking instead of assuming something that is incorrect. So many people believe something, then they tell it to others and that is how misunderstandings occur. Some people still think that the church is against cremation. The church approves of cremation.

This is a personal matter. You are not forced to make specific choices. Hospice care is comfort care. It is up to the individual as to what they choose. Most people at the end of their lives are only seeking comfort and a death with dignity.

My mom recently died with end stage Parkinson’s disease in a hospice house. Her life was not prolonged in any way, shape or form. She was ready to join my father in the afterlife. The hospice house was a blessing. The priest visited mom and prayed at her bedside.

Please call your parish priest with any questions. They will be happy to explain anything that you are interested in knowing.

Best wishes to you.
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I'd say that position contradicts what hospice is.

For example, if you have a stroke and are unconscious, sure, you'd have artificial feeding and hydration until you were conscious again and could eat and drink on your own.

However, if you hit your head and have a massive brain bleed as my FIL (a devout Catholic) did, there is no hope of recovery and no artificial feeding was even considered. My MIL (an even more devout Catholic than FIL, if that's even possible) never thought to do such a thing.

As for hospice, it's about caring for someone who is the end of their life and preserving the quality of their life, not the quantity. My mother has been on hospice for six months and eats very little and is surviving on Ensure. The caregivers encourage her to drink fluids and her Ensure, but when the day comes that she stops taking anything orally even with encouragement, that'll likely be the least of what's going on and she'll be dying. Mind you, she's already done that a few times, but she's refused food and fluids only for a day at a time, then she'll drink again the next day. Missing a day isn't going to kill her, but the caregivers continue to encourage her.

I think the Catholic position is just to avoid euthanasia, which, if you're in hospice care, is not an issue. You'd be perfectly within the teachings of the Church to be on hospice at the end of your life.
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caregiver24x7 Aug 2021
Thank you for sharing your experience with your Mom. My Mom is 94 and has been in home hospice for almost a year. She has gradually stopped eating any 'real food' and will only eat ice cream, cakes, sweets and several hot teas a day, orange juice and water ice. She has lost all of her muscle mass and fat, and is down to 105 lbs. from a used-to-be weight of 175.
She has dementia, is totally incontinent, She has some really good, lucid days but for the most part, just sits all day and not-really-watches tv. Has the Ensure been sufficient to sustain your Mom with nothing else? I have tried giving her the Ensure in a milk shake but she knows it's not a 'real' milk shake. Any suggestions for that?
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Two points of confusion sometimes with hospice:

1) We only bring them on board when someone is "actively" dying.
2) Hospice will discontinue any medical care other than pain meds.

Someone can have a terminal condition but continue to live for many months. Although the general wording is the patient has 6 months to live, no doctor can give you an exact date and sometimes they aren't even in the right ballpark! There have been many postings from others on the forum, including in this thread, where the patient was on hospice for a long time.

As others noted, hospice won't introduce any kind of feeding tube or IV, but if there is an existing one, it can continue to be used, while it is still of benefit to the patient.

This is the same for any medication - if the person is taking meds, they can continue. Sometimes there might be suggestions to cut back or eliminate some medications, if they feel there is no benefit OR if the person can no longer safely take them, but they won't cut them off. Introducing new ones would be the issue. Same for providing other medical interventions for something unrelated to the terminal condition. If the person chooses to get treatment, they have to contact hospice, terminate it and get the treatment desired. Once that is done, the person can go back onto hospice, and keep their meds, feeding tubes, etc.

If you would rather decline the feeding tube, then as others suggested it might be best to discuss with your own priest. The hospice agencies out there can also answer your questions, even if you aren't ready for them yet. They have people who can discuss all the ins/outs of what they provide and what is allowed. We are just lay people here (mostly) so we can only provide the medical/hospice information as we understand it.
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Isthisrealyreal Aug 2021
I have to tell you, my sister had an IV for hydration and hospice told her that she could not keep it and go on hospice.

Definitely needs to be addressed with the hospice provider, they are not all the same.
You are correct that hospice will not have a feeding tube put in, but will honor it if it's already in place. That being said, hospice never withholds food or water from any of their patients, UNLESS they are in the active stage of dying,(where it can be very dangerous and painful if the patient would try to digest anything) and then the patient themselves will refuse any drink of food.

My husband was under hospice care in our home for the last 22 months of his life and continued to eat and drink up until his 6 week dying process started. It was at that point when he was offered food he said no, and for maybe 2 weeks into his dying process only took very small sips of his water.

The human body is created to know when it's time to stop eating and drinking as it transitions to its next state of being. God knew what He was doing when he created us humans, so I certainly wouldn't rule out hospice at end of life, as they can be a real Godsend. You just have to do your homework, as they're all not created equal.
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We are not a nation run by the opinions, rules or laws of any church. We are a nation of laws in which religion is kept separate from state.
Firstly, If death is IMMINENT then this opinion doesn't even figure in the case, as the Catholics make it clear they are speaking of a case where death "is not imminent". (comes out of the Schiavo case). So this is only the case if no physician has said that death is imminent. If hospice is involved, death IS imminent. So the argument becomes irrelevant.
So feel free not to have this administered if the patient expressed to you that he or she doesn't wish to have it. A person has a right to obey or disobey the tenets and opinions of his faith at will. St Peter can sort it all out when we get to the Pearlie Gates.
Secondly, this country has laws that supercede the laws of any church. If you wish to make an advanced directive you can do so, whether catholic or not, and state your wishes for no dialysis, no artificially administered food or fluids whether by tube or by IV. That is your right as a citizen of our country. Faith doesn't figure in this unless you WANT IT TO. Speak with a Priest if you wish before making your directive.
You can research all this for yourself. This came out of the whole "Shiavo broo haha" in which the Catholic "thinkers" thought that Schiavo would not have imminent death if she was fed. There is no written canon about all this; only the opinions of certain bishops and other groups, and you will not have report it as a sin from that I can research. Though, again, discuss with your priest if this is a personal concern for you.
AGAIN LAW supercedes FAITH in our country. Under the law the Catholic has the same right to his own decisions as the non-catholic. so if you as a catholic wish to refuse ANY medication, any food, or any water that is your right if you are adjudged as mentally competent.
St Peter can sort out all the rest of this when you arrive at the pearly gates.
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I would think if you are already on a feeding tube when entering hospice, you can have it. But, a feeding tube will not be inserted once on hospice. When the body starts to shut down, a feeding tube does not help. It would actually hurt a person.
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My mom was a devout and practising Catholic and her AD indicated no artificial hydration or feeding if there was no hope of recovery, or some such wording.

So, if you have a Stage 4 terminal cancer in your GI system that is inoperable, and artificial nutrition would simply prolong the dying process, is it REQUIRED to do that?

There are plenty of Catholic hospices. I would consult one of those orgaizations. Calvary in NYC is the one I know best.
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