If the patient is unable to swallow adequately, forcing food may result in choking. Rather than force or push food on a person who does not want it, offer small amounts of fluids from a favorite glass. If the person is completely unable to swallow, moisten his or her lips. In all cases, stay with the person. See chapter on gastrointestinal problems.
Many people refuse to drink in their final days or hours.
As with food, this may be a way of adapting to the body's diminished ability to function. Indeed, in recent years, we have learned that dehydration in the last days of life is often less of a problem than is over-hydration. Dry mouth and thirst are the greatest problems from decreased fluids in the last days of life. Decreased fluid intake also leads to electrolyte changes, including hypercalcemia. Lips may be kept moist with lightly applied creams.