Nutrition in Hospice Care
The seriously ill patient loses interest in eating and often does not have the energy to eat. The disease process affects a person's desire to eat, as well as the ability to digest foods. It is not unusual for a patient's taste to change from one moment to the next. He/she may ask for a specific food and then refuse to eat it when the food is served.
Although this is normal, it can be very difficult for the caregiver. Remember that the patient is responding to many factors, which result in a loss of interest in eating. Remember that the patient may eat much less than they had before becoming ill.
Things you can do to encourage eating:
- Offer small frequent meals verses 3 large meals a day.
- Eat your meal with the patient - people tend to eat more when they aren't eating alone.
- If able, let the patient come to the table. If not, eat your meal with the patient in the bedroom.
- Give the patient whatever he or she asks for, even if you do not think it is nutritional.
- Supplements like Ensure may be tried or homemade milkshakes or smoothies.
- Above all do not force the patient to eat.
Nutrition in End-Stage Illness
In the last few weeks and days of life, it is normal for the patient to refuse to eat. Usually dying patients do not feel hungry or thirsty; they are not starving. Nature is at work helping them to die in a more comfortable way. Small ice chips, frozen juices or popsicles may be refreshing to a dry mouth. The hospice nurse will give you special swabs to help moisten the patient's mouth. Although the caregiver may feel the patient is not drinking enough fluids, this is actually nature at work.
Decreased fluid intake brings relief from:
- Abdominal bloating
- Pressure from tumors (may decrease pain)
- Shortness of breath
- Lung congestion (breathing that sounds like rattling)
The loss of desire and the patient's refusal to eat are signals that the person is responding to the disease process as the body begins to shut down normal function. Although difficult, the caregiver should respect these signals. The hospice staff is always available to discuss these changes and to help you cope with the dying process of a loved one.
Hospice Patients Alliance. Hospice Nutrition, Artificial Feeding, Constipation and other Considerations. Found at: http://www.hospicepatients.org/hospic28.html
National Hospice and Palliative Care Organization. Commentary and Position Statement on Artificial Nutrition and Hydration. 2010. Found at: http://www.nhpco.org/sites/default/files/public/ANH_Statement_Commentary.pdf