Patient Referral

Hospice Nutrition: 7 Guidelines for Nutrition at the End of Life

Nutrition requirements for those nearing the end of life differ greatly from those currently taking care of them. We usually eat to provide our bodies with nutrients and energy, but when a body is no longer healthy, nutritional needs change dramatically. 

The body of a person with 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 their appetite diminishes. This is a normal end-of-life symptom and is nature’s way of protecting the body.

Guidelines for end-of-life nutrition.

Before we begin, please note that if your loved one is not already on hospice care, it can greatly improve their quality of life, and potentially the quality of the time you have left with them. You can reach out to Crossroads Hospice & Palliative Care at any time to schedule an immediate evaluation. Now, let’s review guidelines for nutrition at the end of one’s life:

1. Small, frequent meals and snacks.

Serve small, frequent meals and snacks that are high in calories and protein. Nutritional supplements or protein shakes can serve as meal replacements and may be better tolerated than larger meals.

2. Small, frequent fluid intake.

Provide small sips of water or juices often, but avoid giving fluids with meals to prevent feelings of fullness. When the patient no longer wants to eat or drink, offer ice chips or flavored popsicles to relieve dryness and discomfort.

3. Ensure slow eating pace.

Encourage the patient to eat slowly and chew food thoroughly. Don’t force food or liquids at any time.

4. Offer good food choices.

Choose high calorie, high protein foods that are easy to eat and digest. Cold foods are often more appealing than hot. Avoid any foods with lots of seasonings or that are especially greasy or salty, and instead opt for bland, soft, moist comfort foods that are nutrient dense. Familiar foods like desserts, soups, or casseroles are often received well. 

Food choices to offer hospice patients can include:

  • Soft fruits and vegetables
  • Fish
  • Chicken
  • Eggs
  • Pudding
  • Jell-O
  • Ice cream
  • Baked beans
  • Soups
  • Shakes
  • Yogurt
  • Trail mix
  • Smoothies
  • Oatmeal 

5. Avoid over-eating and over-drinking.

While the loss of appetite is one of the most difficult symptoms that families experience, if a hospice patient at the end of life is forced to eat or drink when they do not feel the need to, they may experience physical symptoms that can cause more discomfort or complications, which may include:

  • Bloating or an uncomfortable fullness
  • Nausea and vomiting
  • Diarrhea
  • Constipation
  • Gastric reflux (severe indigestion)
  • In extreme cases, aspiration (when fluids or food are inhaled into the lungs)

Even parenteral nutrition or receiving nutrients via IV or feeding tubes can cause complications at this late stage of life. This can include edema, which is swelling within the tissues, as well as “fluid overload,” which can cause many distressing symptoms. Professional hospice care guidance may be necessary to avoid these types of end-of-life nutrition complications.

6. Know the benefits of reduced intake.

The loss of appetite and thirst is a natural process by which the body begins to prepare for death. A reduced intake of food and drink results in less lung secretions, coughing, edema, ascites, nausea, vomiting, and urine output. 

Hospice patients should be allowed to determine what, how much, and how often they eat or drink. Food and fluids should neither be actively forced or withheld. Their bodies will tell them what they need and when they need it. 

7. Fulfill food and drink requests.

Occasionally, hospice patients may have a craving for a particular food or drink. Generally, it is fine to honor these requests unless there are certain restrictions placed on their nutrition. If you are not sure about a specific item, please call your hospice nurse for verification before providing the requested food or beverage.

Contact a hospice professional with questions.

If you have any questions about hospice nutrition or would like further clarification, please call a hospice nurse.  Hospice nurses at Crossroads are available to you 24 hours a day, 7 days a week at 855-327-4677. If your loved one is not on hospice care, let our compassionate and experienced hospice nurses improve their comfort and quality of life. Please reach out to Crossroads now to schedule an immediate evaluation

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