A Prospective Study of Hypodermoclysis Performed by Caregivers in the Home Setting

J Pain Symptom Manage. 2016 Oct;52(4):570-574.e9. doi: 10.1016/j.jpainsymman.2016.04.009. Epub 2016 Sep 15.

Abstract

Context: Decreased oral intake is very common at the end of life. Dehydration can aggravate symptoms, such as fatigue, myoclonus, and confusion. Intravenous hydration at home can be logistically difficult and expensive. Hypodermoclysis is easy to provide and inexpensive; however, it is rarely used to provide hydration at the end of life in the home setting.

Objectives: The purpose of this study was to determine if caregivers were capable of administering hypodermoclysis in the home hospice setting.

Methods: All caregivers underwent a 45-minute training session on hypodermoclysis administration and assessment of infusion site delivered by a specially trained nurse. Caregivers received daily calls and on-site evaluation on Day 8.

Results: A total of 21 patient/caregivers dyads were admitted to this preliminary study: 10 (48%) female patients and 16 (76%) female caregivers. All patients had advanced cancer, receiving hospice care at home. All caregivers who received training were able to start the infusion. The infusion was facilitated by gravity or weight. Side effects were minimal with one (5%) because of the care of the needle and leakage.

Conclusion: This preliminary study suggests that subcutaneous hydration could be administered by caregivers at home with minimal burden, equipment, and technical support.

Keywords: EOL; Hypodermoclysis; delirium; hydration; palliative care.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Caregivers
  • Female
  • Home Nursing* / education
  • Hospice Care
  • Humans
  • Hypodermoclysis* / adverse effects
  • Male
  • Middle Aged
  • Neoplasms / therapy
  • Palliative Care
  • Prospective Studies