Palliative Care: Anorexia & Cachexia - Week 4

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7 Terms

1
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Anorexia vs. Cachexia?

Anorexia = loss of app./decreased interest in eat.

Cachexia - involuntary weight loss → %5 baseline in 6 months

2
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What is nourishments changes and what should you do?

nourishments changes → diff. when healthy vs. sick

  • observe 4 ana & cac → verbal and nonverbal questi. i.e accident weight loss, forget 2 swallow, less eating → ask open ended ques. w. symp. framework → “Our patient quickly remembers symptoms to understand valuable wellbeing”

3
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What to consider with dying patient and family?

  • Consider the role of food in client → culture, fam, community, fav. foods

  • Comfort measures consider → patient & family food pref, dietician, mouth issues, enviroment (ADD/REMOVE), position, for eating in bed, personal eat. space 

    • as disease get worse keep in mind → changing food pref, avoid pressuring, suggest rest/quiet, offer tolerated foods/fluids - keep pref list, prevent mouth dis (sores, ill fit dentures) → good mouth care → O&R

  • Support measure → good comm → educate changes → give fam space to reflect on culture, beliefs values → understanding approach from care team

4
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What is the nutrition truth?

nutrition truth = dying eat less, usually stop eat/drink, nutrition must be flexible, -> more food = worse symptoms & discomfort → patient prefer,. above "values/what is right” _. atmosp. often more important than what’s eaten    

5
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Your client, Mr. Thompson, is seriously ill and has stopped eating. His family is upset and keeps asking if he is starving or if not eating is causing him to die. How would you explain what is happening and support the family?

  • Appetite naturally decreases with illness.

  • Starvation vs cachexia:

    • Starvation → body conserves energy.

    • Cachexia → body breaks down muscle and fat faster than usual.

  • Weight loss is due to disease, not just not eating.

  • Key phrase: “He is not eating because he is dying, not dying because he is not eating.”

  • Validate family’s feelings; provide emotional support.

6
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Mrs. Patel has advanced cancer and barely eats anything. Her daughter is worried and keeps offering food, asking if eating more would help her live longer. How would you explain the situation and support the family?

  • Appetite naturally decreases with illness.

  • Starvation vs cachexia (Mrs. Patel’s body may be in cachexia).

  • Weight loss is due to disease progression, not just lack of eating.

  • “She is not eating because she is dying, not dying because she is not eating.”

  • Support the family emotionally and validate their feelings.

7
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Mr. Lopez has heart failure and has stopped finishing his meals. His wife feels frustrated and insists he must eat to stay alive. How do you explain his decreased appetite and weight loss?

  • Illness often reduces appetite naturally.

  • Starvation vs cachexia: body may be breaking down tissue faster (cachexia).

  • Weight loss is part of disease progression.

  • Reassure: “He is not eating because he is dying, not dying because he is not eating.”

  • Listen to the family’s emotions and provide guidance/support.