Nutrition and Hydration at the End of Life

Nutrition and Hydration at the End of Life 

Changes in a patient’s ability to ingest fluid and nutrition near the end of life requires a thorough assessment, followed by appropriate education and support of both patient and caregivers. An emotionally charged topic that is riddled with misconceptions, this program will help you gain assessment skills and provide a compassionate approach to teaching patients and caregivers about changing nutrition and hydration needs as the patient’s illness progresses.


Hours: 0.75


Certificates provided by accrediting body (5 Match)

Florida Board of Nursing - Certified Nursing Assistants


This is not an accredited course for professional license renewal. Florida CNAs may use this inservice toward meeting their annual inservice requirement.This activity is approved for 0.70 contact hours.

Non-Licensed Direct Care (DSP, HHA, CNA, DCW, PCA, IHA, NA)

0.75 HOURS

Washington State Department of Social and Health Services (ALL Direct Care Workers)

0.75 HOURS

Relias Learning, LLC is approved as a Curriculum Developer by the Washington State Department of Social and Health Services. This activity is approved for 0.75 contact hours for all WA State Direct Care Workers. Training Provider Code: WA0624. CE Approval Code: CO1731212

Texas Health and Human Services Commission

0.75 HOURS

Texas HHSC has determined that Relias Learning’s submitted training meets or exceeds the minimum standards for HCSSA administrator training in the following categories: Hospice. Texas HHSC also recognizes Relias Learning provides continuing education for administrators and alternate administrators. This activity is approved for 0.75 contact hours.

Pennsylvania Personal Care Home Administrators

0.75 HOURS

This activity is approved for 0.75 contact hours.

Course Details

Course Code: REL-HOS-0-NHEL
Hours: 0.75
Type: Online Course
Content Expiration Date: 5/31/2023
Learning Objectives:
Identify potentially reversible causes of decreased eating in advanced illness.
Discuss the emotional impact of changes in eating and drinking on the patient and family.
Utilize simple ways to communicate natural changes related to the dying process to the family.
Describe the benefits of natural dehydration.
Identify risks of tube feeding in the terminally ill.
Discuss ethical, legal, and cultural issues that affect decision-making concerning the use of artificial hydration and nutrition near the end of life.

Section 1: Nutritional Issues A. Learning Objectives B. Clara Doesn’t Want to Eat… C. Examine the “Maybe” First: Is the Cause Reversible? D. Potential Physical Causes of Loss of Appetite E. Medical Causes F. Other Causes G. Changes in Food Preferences H. Initial Approaches to Changes in Appetite I. Clara J. Changes in Eating K. The Mantra L. “Just four more bites!” The Emotional Impact on the Family M. Knowledge Check Section 2: Addressing Nutrition A. The Challenge B. When They Don’t Want to Eat C. Study D. The Truth About Tube Feedings at the End of Life E. Position Statement F. The Initial Goal of Tube Feedings G. The General H. Complication Rates of Feeding Tube Placement I. When DO You Consider a Tube Feeding? J. Use of Supplements K. Why We Don’t Use Appetite Stimulants L. Contrary to Our Best Intention M. Patty and Mat’s Christmas N. When Cytokine is Released O. Don’t Feed the Pig! P. What are we Really Feeding? Q. Encourage Other Ways to Nurture R. Knowledge Check Section 3: Hydration at the End of Life A. Myths About Dehydration at the End of Life B. Consequences of Fluid Overload C. Possible Consequences of Artificial Hydration at the End of Life D. Can There be a Benefit? E. Honoring Religious and Cultural Beliefs F. When We Can no Longer Nourish the Body… G. Knowledge Check

Expert Reviewer: Tani Bahti, RN, CT, CHPN
An RN since 1976, Tani Bahti has spent most of her career in the field of hospice and palliative care. Recognizing how fear, misinformation and lack of information can negatively impact decision-making and the dying experience, she is passionate about, and committed to improving end-of-life care through education. Certified in both Thanatology and Hospice and Palliative Nursing, a frequent lecturer for medical and nursing schools and community groups, Ms. Bahti has developed clinical training programs for healthcare professionals and volunteers, participated in end-of-life research and produced teaching tools. She is the writer and producer of the award winning video, Living Through Dying - The Struggle for Grace, and author of Dying to Know - Straight Talk About Death & Dying. Ms. Bahti is the Founder and Executive Director of the non-profit organization, Passages – Support & Education in End of Life Issues. Disclosure: Tani Bahti, RN, CT, CHPN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: Entry, Intermediate level Direct Care Workers; in the following settings: Hospice, Palliative Care.
F Tags:
F684, F692
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form ( or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
If you require special accommodations to complete this module, please contact Relias Customer Support here.