There are a few symptoms associated with dehydration, but each is easily managed. Family members and others close to the patient are more than capable of helping to alleviate the most common symptoms.

Symptom (likelihood)	Management strategy
Thirst (rare)	Thirst is experienced in only a small percentage of dehydrating patients at the end of life and it is never hard to alleviate. In one study of 96 hospice nurses, 73 percent indicated that dehydrated patients rarely complained of thirst (Andrews and Levine, 31). What thirst mouth does develop can easily be relieved sips of water, ice chips, and hard candies to suck on. (The small amount of water it takes to satisfy pateints who are thristy will not significanlty delay the process of dehydration.)
Dry mouth (common)	Compliment sips of water and ice chips with use of lip moisturizer and glycerine swabs. Provide good skin care and appropriate mouth hygiene and check to make sure side effects of medications are not exacerbating the condition. If inflamation develops it can be treated with diphenhydramine liquid (an antihistamine medication) and viscous lidocaine (a local anaesthetic).
Neuromuscular irritability (rare)	A small percentage of patients electrolyte imbalance may lead to neuromuscular irritability and twitching, both of which are easily treated with sedation: Ativan (a benzodiazepine type sedative used to depress central nervous system) or morphine are commonly used.
Pain (rare)	Benzodiazepines (class of drug used to depress central nervous system) and morphine are most commonly used.
Nausea (rare)	Nausea is easily controlled with antiemetics (drugs used to prevent nausea or vomiting).
Other symptoms (rare)	Bedbound patients may also report varying degrees of lethargy, drowsiness, and occasionally fatigue, but these symptoms are rarely a source of much distress.

A note about medication: Oral or sublingual (beneath the tongue) delivery of medications in pill or gel form are most commonly used at the end of life; usually, medications are given via intravenous injection, intramuscular injection, or via rectal suppositories only if oral or sublingual methods are unavailable.

Citations

Andrews, Maria R., and Levine, Alan M. 1989. "Dehydration in the Terminal Patient: Perception of Hospice Nurses," The American Journal of Hospice Care. January/February, pp. 31-34.

Billings, J. Andrew. 1985. "Comfort Measures for the Terminally Ill: Is Dehydration Painful?" Journal of the American Geriatric Society. Vol. 33, pp. 808-810.

Brody, Howard, Campbell, Margaret L., and Faber-Langendoen, Kathy. 1997. "Withdrawing Intensive Life-Sustaining Treatment -- Reccomendations for Compassionate Clinical Management," New England Jouranl of Medicine. Vol. 336, pp. 652-657.

Hastings Center. 1987. Guidelines on the Termination of Life-Sustaining Treatment and Care of the Dying. Briarcliff Manor, N.Y.: Hastings Center.

Lynn, Joanne, and Harrold, Joan. 2001. Handbook for Mortals: Guidance for People Facing Serious Illness. New York: Oxford University Press, pp. 129-138.

McCann, Robert M., Hall, William J., and Grath-Junker, Annmarie. 1994. "Comfort Care for Terminally Ill Patients: The Appropriate Use of Nutrition and Hydration," Journal of the American Medical Association. Vol. 272, pp. 1263-6.

Maillet, Julie O’Sullivan, and King, Dorothy. 1993. "Nutritional Care of the Terminally Ill Adult," The Hospice Journal. V. 9, pp. 37-54.

Post, Stephen G. 1990. "Nutrition, Hydration, and the Demented Elderly." The Journal of Medical Humanities. Vol. 11, pp. 185-192.

Printz, Louise A. 1988. "Is Withholding Hydration a Valid Comfort Measure in the Terminally Ill?" Geriatrics. Vol. 43, pp. 84-88.

Schmitz, Phyllis, and O’Brien, Merry. 1989. "Observation on Nutrition and Hydration in Dying Cancer Patients." In Joanne Lynn, ed., By No Extraordinary Means: The Choice to Forgo Life-Sustaining Food and Water. Bloomington, Ind.: University Press, pp. 29-38.

Sullivan, Robert J. 1993. "Accepting Death without Artificial Nutrition and Hydration," Journal of General Internal Medicine. Vol. 8, pp. 220-224.

Sutcliffe, Jayne. 1994. "Palliative care: Terminal dehydration," Nursing Times, Vol. 90, pp. 60-3.