Assistance of a Registered Dietitian as a Medical Team Member for a Terminal Phase Patient

Abstract

Introduction: Assistance with eating is recognized to be important for terminal phase patients who have difficulty in eating and efforts have been made in accordance with the patient’ s condition. We provided eating assistance for a terminal phase patient with lung cancer who was about to give up eating meals with relatives. We report this case who regained motivation and could eat meals with the assistance of a registered dietitian.

Case report: An 83-year-old woman suffered from right lung cancer. She wished to eat meals with relatives, but was admitted to our hospital due to difficulty in eating caused by increasing pain and dyspnea. The pain and dyspnea decreased by day 10, but then increased on day 12 due to pleural effusion. She could not eat enough, lost motivation for eating, and almost gave up eating meals with relatives. On day 15, a registered dietitian checked the eating status and found that the problem was not swallowing dysfunction but dyspnea during eating. She re-evaluated the food texture and changed to a dysphagia diet for easy mastication. The patient regained motivation for eating due to decreased dyspnea, so the medical staff and family coordinated staying overnight at home. On day 18, the patient could remain out of hospital and eat meals with relatives.

Discussion: In this case, we considered that dyspnea during eating caused the difficulty in eating and the patient accepted the dysphagia diet for easy mastication. In addition, we were able to prepare for the patient to be discharged early from hospital by sharing information among team members. We recognized anew the importance of providing eating assistance for terminal phase patients. We plan early intervention via cooperation among team members and wish to help not only in terms of food texture, but also patients’desire to eat.