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Hospice care guidance: nutrition at the end of life.

For centuries, food and drink have played a significant role in socialization within our society. We typically associate food and drink with pleasurable activities, such as birthday parties, holiday meals, or tailgating at our favorite football games. In our minds, food and drink symbolize caring, love and happiness.

The biological reason we eat is to provide our bodies with nutrients to promote good health and provide energy. But, when a body is no longer healthy, nutritional requirements dramatically change. A hospice patient’s nutrition at the end of his or her life differs greatly from that of a healthy person’s. The body of a person who has a life-limiting illness is in the process of shutting down. They no longer require a great deal of nutrients or calories to convert to energy and therefore, their appetite or desire for food diminishes. The person at the end of life does not experience hunger or thirst in the way a healthy person does. This is an expected and normal process and is nature’s way of protecting the body.

The loss of a loved one’s appetite may be one of the most difficult symptoms that hospice families experience. It is commonly feared that your loved one will “starve to death” or become dehydrated and you may fear that your loved one will suffer. In fact, the opposite is true. Although adequate nutrition while in hospice care is important, if a person with a life-limiting illness in the later stages of their disease is forced to eat or drink when they do not feel the need to do so, they may experience physical symptoms that can cause more discomfort or complications.

Complications such as bloating or an uncomfortable fullness can occur. This can lead to nausea and vomiting, diarrhea and/or constipation. They can experience gastric reflux (severe indigestion) and in extreme cases, it can cause someone to aspirate. Aspiration is when fluids or food are inhaled into the lungs. Even the introduction of IV fluids at this late stage of life can cause complications such as edema, which is swelling within the tissues, as well as “fluid overload”. Fluid overload can cause many distressing symptoms. Some hospice care guidance from a trained professional may be necessary to avoid these types of end-of-life nutrition complications.

The loss of appetite and thirst is a natural process by which the body begins to prepare itself for death. That’s why we would strongly suggest your loved one be allowed to determine what, how much and how often they choose to eat or drink. Food and fluids should neither be actively forced nor actively withheld. Their bodies will tell them what they need and when they need it. Occasionally, your loved one may have a craving or request a particular food or drink. Generally speaking, it is fine to honor these requests unless there have been severe restrictions placed on your loved one’s nutrition at the end of life. If you are not sure about a specific item, please call your hospice nurse for verification before providing the requested food or beverage.

If you have any questions about hospice nutrition or would like further clarification, please don’t hesitate to call your hospice nurse. Your Crossroads Hospice nurse is available to you 24 hours a day, 7 days a week.