ABSTRACT

There is a sound clinical and ethical rationale for the provision of nutritional support to people receiving palliative care. Stabilising, maintaining and even increasing weight mediate some of the metabolic and other physical wasting effects of the disease and treatment process as well as reduces discomfort for people. Quality of life (QOL) is a multi-dimensional measure that includes domains relating to physical, psychological and social well-being and functioning. It is a comprehensive concept that measure more than just health and disease outcomes. It is suitable for measuring the effects of nutritional support interventions delivered to people receiving palliative care. Generic QOL measures can accurately measure the QOL of people receiving palliative care. Specifically designed QOL measures include spiritual, existential and family/friend support domains which are seen as unique to palliative care.

Weight stabilisation and weight gain provide people with the energy to help them fulfil their physical, psychological and social functioning needs. The benefits of nutritional advice/counselling are maintained for longer. The anti-inflammatory effects of nutritional supplements such as n-3 polyunsaturated fatty acids have an effect on moderating some of the metabolic processes associated with tumour growth and cancer. This outcome has a positive effect on QOL. Generally, people receiving artificial nutrition have a lower QOL compared to the general population. Perceived and real length of survival have an effect on QOL and mean that improvements in weight stabilisation, survival and QOL are only temporary and tend to reverse up to 2 months prior to death.

There are only limited studies exploring the effects of nutritional support on the QOL of people receiving palliative care. Many studies include people with cancer at different stages of the disease process and not necessarily receiving palliative care. The findings of these studies provide clues about trends rather than definitive support for the relationship between nutritional support and QOL of people receiving palliative care.