Enteral nutrition is a form of nutrition for those sick who cannot be fed through the mouth. For many of them, this is the only chance to nourish the exhausted body. Enteral nutrition, however, in patients in their relatives has many concerns. We dispel them together with the psycho-oncologist Adrianna Sobol from the "OnkoCafe - Better Together" Foundation.

Enteral nutrition is a necessity or a choice?

Adrianna Sobol:For patients who, for various reasons, cannot be fed orally, it is definitely a must. I would say - the utmost necessity, because only such nutrition ensures that they simply keep the organism alive. Therefore, patients have no choice but to "switch" to such nutrition. But that doesn't mean they do it willingly. Usually they "figure out" as much as possible to avoid it. There are those who delay the transition to this type of nutrition, others belittle it and joke "because home-made broth is the best and no mixture can replace it."

And aren't these masks covering the fear of the unknown?

A.S.Absolutely. The term itself: enteral nutrition is terrifying for patients. After all, food has a lot of symbolism. It is a pleasure, it builds, nourishes, gives strength - also to fight disease. How many times have we heard or said:eat, you'll be he althier ? So, when a sick person hears: enteral nutrition, he thinks:yeah, it's so bad with me that I can't even eat anymore, they will only give me something through a "tube", and if I won't ate it I will die . The patient does not think about enteral nutrition but about a different form of food and a different way of administering it to the body. He does not understand that enteral nutrition relieves pain (e.g. in the esophagus), supports treatment, and helps to improve the quality of life in a disease.

I would be more afraid if I would be able to handle feeding through this "tube" or a probe …

A.S.Such fear: is this medical procedure complicated and whether I will learn it - is also expressed by many patients. And there are other fears that torment them. Will I not become a burden for my relatives, because it is a daily duty. How will I wash and dress with the tube? And if they let me go back to work, how am I supposed to serve flats among people? Will my partner / partner, wife / husband, children be ashamed of me? Will I have togive up your intimate life …?

Can the patient be prepared for enteral nutrition?

A.S.Yes, if possible by time. It is done by doctors and nurses, or mainly nurses, because they are the closest to patients, they have the greatest influence on them. They teach and dispel doubts not only in the patients themselves, but also in their relatives. Nurses and doctors also take care of the patient who is fed enterally at home, because in Poland we have reimbursed nutritional care at home, provided by nutritional clinics. Thanks to this, the patient and family are not alone with it. The better prepared the patient is for a new formula of nutrition, the easier it is for him to accept it and recognize it as a natural part of treatment and living with the disease. However, it is not always possible to prepare a sick person for this change …

Exactly: and when the patient suddenly learns that he will be fed enterally …?

A.S.This is the most difficult situation, because for many of them it is such a small, private "end of the world". Patients often experience shock, cry, push it out, become depressed. There were even "escapes", that is, leaving the hospital at your own request. You have to have a lot of understanding for them at this time. This is how they experience "mourning" for what they have lost. I work in an oncology ward and I am often asked for an intervention. I explain to patients that enteral nutrition is nothing wrong, just another form of support for treatment, relief from pain and other ailments. I leave this in the mind of the patient and his relatives, because it is a hope for a normal life.

What happens when this panic is over? Because it passes, right …?

A.S.Fortunately, yes. And when it passes, the sick person and their loved ones move on to the next stage, i.e. searching for knowledge - answers to the questions: what awaits me, how will my life change? Emotional crises can also occur at this point. Or because the sick person came across unprofessional information that terrified him. Or when he begins to understand that he has to "learn himself" all over again.

Can the relatives of the patient help him?

A.S.Yes, but only if they know how. And such a message must come from the patient himself. He often thinks that his relatives will just guess, or even should (!) Know what help he needs. And that's not true! It is the patient who has to clearly define what support he / she expects in order to adapt to the new life together with the relatives. But also on the other hand, we cannot blame a sick person if he / she cannot specify his needs. That is why the so-called inter-patient support. That families of enteral patients would share their stories andexperiences.

Please give a hint, what are the pillars of proper care for a patient fed enterally?

A.S.They are in my opinion 3. The first is knowledge from a proven source, i.e. from a doctor, nurse. I encourage you to write down the questions that appear on a regular basis so that we do not miss anything. If a sick person or a loved one asks specific, factual questions, it also builds a good relationship with the doctor. The second pillar is psychological support. Please do not be afraid to seek the help of a psychologist who specializes in your disease. These are the people who will help you to deal with "grief" and to avert or deal with already existing crises in a timely manner. Third pillar - to speak openly to others about the disease and the new form of nutrition. Do not deny, do not use metaphors, do not put up barriers. The more honest we are, the easier it is for us to cope with a new experience - including enteral nutrition.

Adrianna Sobol

Psychooncologist at the Magodent Oncology Hospital in Warsaw. Assistant (researcher and lecturer) at the Department of Oncological Prophylaxis at the Medical University of Warsaw. Member of the Board of the "OnkoCafe - Together Better" Foundation, psychotherapist and founder of the Ineo Psychological Support Center. She created the online training platform "Everything starts in the head". Co-creator of the radio program " O raku at coffee " on Radio RPL. Author of numerous publications in the field of psycho-oncology and he alth psychology. He acts as an expert in television programs, co-creates campaigns and social campaigns, conducts trainings and workshops.

Category:

Gastrology