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When They Won’t Eat

There will be a time in most terminal illnesses when a person feels no desire to eat or drink. The issue of nutrition can be one of the most guilt-inducing, frustrating and emotionally charged issues affecting patients and families. That’s because we think of food as much more than fuel. We think of it as comfort, enjoyment and protection. We also think of eating as a way to prolong life.

It is very hard for family members to see their loved one with no appetite or unable to eat.

A common reaction is to want to begin nutritional supplements, tube feedings or even IVs with the idea that “it couldn’t hurt.” In fact, these measures often cause unnecessary harm and discomfort. 

When your loved one is nearing the end stage of life, very little fuel is needed. To complicate this, often nothing tastes good to the patient. As caregivers we sometimes think this means the patient is being stubborn, willful or—even worse—giving up. In reality, the body is responding to the disease process and is trying to shut down the normal function.

Why This Happens:

When people stop eating, it is a physical sign that their bodily needs are drawing to a close. Dying takes no nutrition. Sometimes eating stops when a disease progression prevents swallowing or digestion of the food. Eating requires energy, and it is normal for the body to decline food and fluids.

Remember, people are not dying because they are not eating; they are not eating because they are dying.

Positive Effects of Dehydration:

While it can be difficult to watch your loved one refuse food and drink, these changes can actually be helpful for him or her. Nature is at work assisting the person to be more comfortable in the following ways: 

  • Decreased body fluids, a lower level of consciousness, and chemical changes cause a natural decrease in pain perception.
  • With decreased intake, there will be less saliva produced. This will help decrease secretions and congestion.
  • There will be less buildup of the gastrointestinal fluids which could cause nausea and vomiting.
  • Less urine is produced.

How You Can Help:

  • The dying person may appreciate small amounts of foods, snacks or fluids.
  • Breakfast may be the best meal in the day. Appetite tends to decrease later in the day.
  • The person may appreciate ice chips, frozen juice or popsicles as they are refreshing to the mouth.
  • If your loved one is able to swallow fluids, they can be given by a sippy cup or spoon.
  • When the person is no longer able to swallow, never give food or fluids, as it may cause choking. Continue with good mouth care.
  • Keep your loved one clean and dry. With the decreased urine output your loved one may be comfortable in using chux or a diaper instead of the bedpan or commode.
  • Keep the mouth moist using moistened mouth swabs, ice chips or small amounts of cool liquids. Lip balms can maintain moisture on the lips.

Sometimes the best solution is to hold the chicken soup and substitute love.