A hospice nurse has explained why people nearing death often stop eating and drinking, and why this natural process can lead to a more peaceful end. Julie, a bestselling author who works in palliative care, shared her insights in a TikTok video with her 1.8 million followers.
Why the body stops wanting food and water
In the hours or days before death, it is common for patients to refuse food and water. Julie said this is not usually a problem that needs treatment. In fact, limiting food and water can make the dying process more peaceful.
Julie said: "I get the most heat for saying this one thing, including from other health care workers, and that's when I say people who are dying should be dehydrated. I know that can sound so jarring, so let me explain to you why."
She explained that when a person is dying from an illness, the body begins preparing itself. "The body knows how to die – it has built-in mechanisms to help it do that," she said. One of these mechanisms is reducing hunger and thirst, so the person naturally loses interest in eating and drinking.
Families often worry
Families can become distressed when a loved one refuses food or drink, fearing it will hasten death. But Julie said: "What you have to remember is people dying are not dying because they're not eating and drinking. They're not eating and drinking because they're dying and our body knows this... The body will actually go into ketosis where it releases endorphins that make that person feel good and feel better."
She also noted that a dying person does not experience the same desperate thirst a healthy person would feel after exertion or in heat. "It doesn't feel like that where you have a headache and other things. It doesn't feel like that. The body actually prepares itself to be dehydrated," she added.
Why IV fluids can cause harm
Some families may insist on an IV drip, but Julie warned this can do more harm than good. "If a healthy body got IV fluid, the healthy body would feel better, they'd get hydrated and instantly start feeling better," she said. "But when a dying body gets hydration, it doesn't do what it's supposed to do."
The fluid can cause swelling, typically in the lower extremities, before reaching the heart. She explained: "The heart will say it can't keep pumping this fluid around the body, it's too much. It will then back up into the lungs and cause respiratory distress."
Excessive hydration in a dying body can therefore lead to a less peaceful death. Julie concluded: "Moral of the story. Dehydration at the end of life does not cause suffering and can in fact cause a more peaceful death."
What the NHS says about end-of-life symptoms
The NHS agrees that "physical changes are likely to happen when you're dying", and these can occur over hours or days. Common symptoms include feeling very sleepy, eating and drinking less, changes in breathing, confusion or hallucinations, and cold hands and feet.
The NHS advises that a healthcare professional can discuss these symptoms with families who have concerns.
