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Nutritional Concerns at the End of Life

Shot of a cheerful group of senior people talking and enjoying breakfast together at home

Eating is a social act. We share food with family and friends as a means of nurturing both our bodies and connections with each other. It is an expression of our culture and heritage, and central to the holidays and rituals we celebrate.

In its more basic sense, we know that food is sustenance. We need the nutrients from food to provide energy and fuel our bodies’ many processes. Yet for patients who are nearing the end of life, they often feel little to no hunger or thirst, and it can be upsetting for families and friends to witness. Understanding why their loved one has little desire for food or drink can help to alleviate these kinds of concerns, and can empower us to better support them during this emotional time.

Understanding the Role of Nutrition in Palliative and Hospice Care

The primary goal of both palliative care and hospice care is to ensure a patient’s comfort and wellbeing, by managing as many of their symptoms as possible. Nutrition plays a very different role in these two types of care.

In palliative care, dietary changes may be necessary, but food remains a major source of nutrition for the patient. While appetite may be lessened, it is still beneficial for patients to receive some form of nourishment if they have the ability and desire to eat and drink. Snacks like trail mix, smoothies, yogurt or oatmeal are all nutritionally-dense foods that can provide the patient with nourishment without overwhelming their systems with larger meals. Family members can also offer them familiar foods like desserts, soups or casseroles, which can be very comforting.

In hospice care, food becomes less important as care is shifted towards comfort measures only. The body is no longer able to process nutrients from food, so meals are typically not recommended unless they bring comfort and happiness to the patient. Throughout life, our bodies work hard to grow, build and repair, but the opposite takes place at the end of life. This transition requires significantly less in the way of nutrition.

Fluids are also typically given sparingly in hospice care due to decreased kidney function, but can be offered when appropriate and if desired by the patient (such as sips of coffee for someone who enjoyed their daily cup). Ultimately, whatever brings peace and joy to the patient should be considered even though it may not always involve traditional meals or snacks.

Concern Around Hospice Patients Not Eating or Drinking

It is very common for families and friends of the dying to become distressed about their loved one’s lack of desire for food or drink, especially if they are lingering for days or weeks. There is understandably much concern about starvation or dehydration, and often a feeling that they or their caregivers are “giving up” on their loved one if food or fluids are not being given. Family and friends may not know forcing food and water, or opting for artificial nutrition or hydration, can actually complicate the dying process and lead to other health problems like nausea, vomiting or aspiration. Understanding this can alleviate concerns and allow friends and family to spend precious remaining time with their loved one, providing them with the support they truly need.

How We Can Support Our Loved Ones Receiving Palliative or Hospice Care

As hard as it may be, friends and families are encouraged to honor their loved one’s cues when it comes to eating and drinking. There is much we can do to show them our love and support. For example, we can provide:

  • Smaller, easy-to-eat comfort foods
  • Calorically dense foods like nutritional drinks, shakes or smoothies when eating a meal takes too much energy
  • Eating or drinking from fancy or familiar dishes
  • Help with good oral hygiene: mouth swabs, lip balm or ice chips when appropriate
  • Good positioning while eating and drinking — always upright
  • Comforts like music, loving touch, reading to them, pet visits, watching television, prayer and companionship

At Anew Hospice and Anew Palliative Care, we are committed to delivering outstanding service to our patients and their loved ones. Creating a positive experience is our priority, and we achieve this by providing specialty services that exceed traditional standards of care. Visit us at to learn more about our services, and how we can help your loved one during this pivotal time in their lives.

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