Chapter 2: Meals and feeding
When the person’s appetite gets smaller
As a person’s illness advances, they generally eat and drink less. This is usually caused by a combination of things such as their medications, their overall disease burden, their ability to safely swallow, and their energy. Click the arrows to see some signs that may indicate the person’s appetite is changing.
Decreased interest in eating
Appetite is unpredictable
Skipping meals
Eating smaller amounts
Refusing formerly favourite foods
Commenting that everything tastes the same
Changes such as dwindling appetite and weight loss may be difficult for friends and family to accept, but it is important to realize that this is a common occurrence at end of life. Of course, you want to provide nutritious meals, but it is even more important to make eating a pleasurable time – ideally spent with someone whose company the person enjoys, eating foods they like, and consuming as much or as little as they choose.
Considerations
As disease advances
As a person’s disease advances, eating and drinking serve a different purpose.
There is a point at which an ill person’s body is unable to use the nutrients in food like a healthy body can. As death approaches, eating and drinking may cause discomfort, nausea, or a bloating sensation. Understandably, family members often find it difficult to see the person not eating or drinking, and they feel helpless not being able to nurture them in the way that is most familiar to them: by providing food. The focus should shift to “eating for comfort,” as long as it is safe for the person to swallow.
Typically, how much liquid the person drinks will decrease. Although they may not feel thirsty, people nearing death often become dehydrated, which is a normal part of the natural dying process. While the dying person may no longer be drinking liquids, caregivers can provide mouth care with a moist sponge or cloth, or with commercially available moisturizing sprays, or they can offer popsicles.
What may help
- Offer small amounts of food more frequently.
- Encourage the person to eat when they choose, not out of obligation.
- Cold foods may become more appealing (sometimes the aroma of hot food is disturbing, so you may not be able to eat with the person who is ill).
- Bland foods will probably be preferred to spicy.
- Serve drinks between meals rather than with meals.
- As energy lags, it might also be a good idea to use lighter weight cutlery.
