Consider the purpose and intended outcome of the intervention and the trajectory of the disease. Meet with patient and family to ensure they have adequate information to be aware of the prognosis of the life-limiting illness and then consider their goals of care and whether the intervention is consistent with these. Support ordinary means of care which the patient judges to provide a reasonable chance of benefit and does not involve excessive burden (pain, risk, expense) to the patient or family.
Interventions such as tube feeding and IV hydration may offer benefit in some cases with those pursuing disease targeting treatment. These may not address other symptoms such as dry mouth or hunger while carrying risks of consequences such as fluid overload and discomfort. For those with advanced illness and cachexia, these interventions are unlikely to improve quality of life.
Sources:
Zametkin E, Guyer D, Tarshish Y, Bash K, Almhanna K. Total parenteral nutrition for patients with gastrointestinal cancers: a clinical practice review. Ann Palliat Med. 2023 Sep;12(5):1072-1080. Epub 2023 Aug 21. PMID: 37691334.