Thirst or dry mouth in dying patients?—A qualitative study of palliative care physicians’ experiences

by Maria Friedrichsen, Caroline Lythell, Tiny Jaarsma, Pier Jaarsma, Helene Ångström, Micha Milovanovic, Marit Karlsson, Anna Milberg, Hans Thulesius, Christel Hedman, Nana Waldréus, Anne Söderlund Schaller

Thirst and dry mouth are common symptoms among patients at the end of life. In palliative care today, there is a focus on mouth care to alleviate thirst. There are no qualitative studies on thirst from a physician’s experience, which is why this study is needed.

This study aimed to explore palliative care physicians’ experiences and views of thirst in patients at the end of life.

A qualitative interview study with an inductive approach was carried out. Sixteen physicians working in specialised palliative care units in Sweden were included. The interviews were analysed with a reflexive thematic analysis.

The analysis resulted in three basic assumptions regarding thirst: It is dry mouth, not thirst; patients are dry in their mouth and thirsty; and, I do not know if they are thirsty. Further, four different themes regarding how to relieve thirst appeared: drips will not help thirst but cause harm; the body takes care of thirst itself; drips might help thirst; and, mouth care to relieve thirst or dry mouth.

The palliative care physicians had different experiences regarding thirst, from thirst never arising, to a lack of awareness. They thought good mouth care worked well to alleviate the feeling of thirst and dry mouth. Most physicians did not want to give patients drips, while some did. This study indicates that there are many unanswered questions when it comes to thirst at end-of-life and that further research is needed.