"Não me deixe morrer de fome": nutricionistas e a não alimentação de pacientes em cuidados paliativos nas situações de terminalidade da vida

Abstract

Palliative Care (PC) corresponds to an approach that promotes quality of life for patients and their families, in the face of a life-threatening disease. Food is part of this care. Failure to feed the patient in specific situations is a conduct fraught with discussions. The objective of this study is to understand how nutritionists deal with the lack of food and nutrition of their patients in PC. We conducted a qualitative research with 7 nutritionists, using narrative interviews and a workshop using projective scenes. The interpretative analysis was anchored in Gadamerian Hermeneutics. In the dialogue with the narratives we have the meaning of death in personal and professional life marked by pain, unpreparedness, and the absence of the theme of death in training. The meaning of food in care consists of promoting physical and emotional well-being for the prevention, treatment and recovery of the individual, respecting their food history. Palliative Care is to promote quality of life until the end, taking care in a multidisciplinary way with respect and affection, not only in the terminally, including also the mourning. In the process of dying, food, in addition to recovering, means providing comfort through the pleasure of food. Not eating at the end of life encounters challenges in the team, in communication in the face of death signals and in impotence in the face of not saving and not feeding with pleasure that require learning and reframing to deal with their own pain. In practice, they discover the power of caring without feeding, but seek to fulfill their desires at the end of life, still with the pleasure of eating. Do not let them die without comfort, they also comfort them, feeding or not. May this work be one more interlocutor in the search for nutrition that feeds happiness in life and in dying.