#151 Food and fluids in the last days of life with Dani & Clare

Exploring words and busting myths associated with palliative and end of life care. Over the course of 10 podcasts I am delighted to talk with Dani Aye season, we will focus on a word a week and challenge commonly held beliefs. Why? Because words matter - you will hear the impact of myths around words and we’ll share valuable resource.

In episode six we talk about nutrition and hydration in the last days of life, listen in and share the conversations.

Key messages

• The episode focuses on Advance Care Planning, particularly “feeding and fluids” at the end of life.

• We discuss the role of food and fluids in showing love and care within different cultures.

• Dani & I share common misconceptions: Ordinary Dying dying versus withdrawal of nutrition/hydration, and why terms like “nil by mouth” are misleading.

• We emphasise“taste for pleasure” and “taste for comfort” over nutritional needs in the final days/hours of life.

• Dani & I talk about the importance of  individualised care: each patient’s needs considered, with no blanket rules regarding nutrition or hydration.

• We explain that providing food or fluid at the end of life can sometimes cause more harm than benefit and stress the importance of communication with families to manage expectations and reduce guilt or misunderstandings.

• We talk about dying as a social, not purely medical, event and encourage families to focus on comfort and memory making.

• Dani & I call for public education to dispel myths regarding food/fluid at end of life and recommend resources by Dr Kathryn Mannix.

• In closing we share a vital key message: in ordinary dying, people stop eating/drinking because they are dying, not the other way round.

Resource

• NICE Guidance available at: Care of Dying Adults in the Last Days of Life QS 144

• Dr Kathryn Mannix videos can be found at:

  •  Dying is not as bad as you think 

  • What happens as we die? | Kathryn Mannix | TEDxNewcastle

  • Dying for Beginners | Dr Kathryn Mannix

  • CHELsea II  A Cluster randomised trial of clinically assisted hydration in patients in the last days of life.

Bio

Dani Ayre

Dani is Matron and Lead Nurse for Palliative Care currently working at Norfolk and Norwich University Hospital. She has over 15 years’ experience in Palliative and End-of-Life Care (PEoLC). She previously worked in Gibraltar for over 8 years, implementing and leading a Hospice Outreach Service for the community of Gibraltar. She has also worked in the community in Palliative care and Long Term conditions and briefly in the acute sector. 

Dani has furthered her knowledge throughout her career by achieving a Distinction in her PG Certificate at Masters level in Palliative Medicine and completed 2 further Masters modules in leadership and education in Palliative care. She is passionate about raising awareness and educating on Palliative care and the importance of Advance care Planning  not only to Health care professionals and the general public.

Clare Fuller

Clare is a Registered General Nurse and has focused her career in Palliative and End of Life Care (EoLC) working clinically in hospices, providing clinical support and education in the acute setting and nationally to deliver the Gold Standards Framework Acute and Primary Care programme. Clare holds an MSc in Specialist and Advanced Health Care and in 2025 was proud to be part of the Parliamentary Palliative and End of Life Care Commission.

Clare has worked strategically in a CCG focusing on delivering the Workforce element of the General Practice Forward View and as a CQC End of Life Care Specialist Advisor.

In 2019 Clare founded Speak For Me which provides Advance Care Planning Education, Lasting Power of Attorney Consultation and support for people facing a life changing illness. Clare advocates for proactive Advance Care Planning and is host of the podcast Conversations About Advance Care Planning.