Can I give water to someone who is having trouble swallowing?
Water may be unsafe if a dying person is too sleepy or weak to swallow properly.
Water may be unsafe if a dying person is too sleepy or weak to swallow properly. If they are awake, asking for a drink and able to swallow, small sips may be comforting. If they are drowsy, coughing, choking or unable to swallow, do not pour water into their mouth.
The safest choice depends on the person and their care plan. Ask the palliative care team, nurse, GP or aged care staff what to do.
General information: This page gives general information for people in Australia. It cannot tell you exactly what is happening in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional.
Why swallowing changes near death
Near death, the body becomes weaker. The person may sleep more, have less saliva, cough less strongly, and lose the strength needed to swallow safely. Food, drink or tablets can sit in the mouth or go down the wrong way.
Forcing food or drink at this stage can be distressing and may cause more discomfort. Solid food can also cause choking if swallowing is poor.
When small sips may be okay
Small sips may be suitable if the person:
- is awake enough to ask or clearly show they want a drink
- can sit up or be positioned safely
- can swallow without repeated coughing
- does not become wet-sounding or distressed
- has a care plan that allows sips.
Use a small cup or teaspoon if advised. Go slowly. Let the person decide when to stop.
When not to give water
Do not give water by mouth if the person is unconscious, very drowsy, unable to swallow, choking, coughing repeatedly, or holding fluid in the mouth.
Do not use a straw unless the team says it is safe. A straw can deliver fluid too quickly for someone with a weak swallow.
Do not try to make up for low fluid intake by pushing drinks. Reduced drinking is often part of the dying process.
What to do instead
Mouth care can ease dryness without making the person swallow. A nurse may show you how to use moist swabs, clean the mouth, apply lip balm, and position the person safely.
If the person is thirsty but swallowing is unsafe, ask whether mouth gel, artificial saliva, ice chips, thickened fluids, or another option is suitable. Some options are not safe for everyone.
If medicines are normally taken by mouth, ask what should happen now. Some medicines may be stopped. Others may be given under the skin, through a syringe driver, or by another route.
What to ask the team
You can ask:
- "Is it safe for them to drink?"
- "What signs mean I should stop?"
- "Should we use a spoon, cup, swab or something else?"
- "Do they need thickened fluids?"
- "What happens to their tablets if they cannot swallow?"
- "How often should we do mouth care?"
When to get help now
Contact the care team urgently if the person chokes, coughs repeatedly with fluids, becomes suddenly breathless, has a wet voice or noisy breathing after drinking, or cannot swallow medicines needed for comfort.
Call 000 if choking or breathing difficulty is sudden and life-threatening and there is no end-of-life plan telling you what to do.
You may also want to read
- How do I do mouth care for someone who is dying?
- What can I use for a very dry mouth at the end of life?
- Why does someone who is dying stop being able to swallow tablets?
- They've stopped eating and drinking. Are we starving or dehydrating them?