Hospice patients often have changing patterns of eating and drinking. 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.”

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.

The patient is not starving. Nature is at work assisting the person to be more comfortable.

Published facts now indicate that the use of forced nutrition in the terminally ill person is questionable and may actually worsen the patient’s condition. IV hydration or forced feeding can lead to several harmful effects, including tumor growth, more nausea and vomiting or the development of serious infections. Any weight gain experienced is usually due to fluid retention and can cause difficulty breathing.

Allowing the patient not to eat is in no way negligent; rather it is in the best interest of the patient.

This does not mean that nothing can be done when your loved one’s appetite diminishes. Your hospice nurse can discuss things that may be helpful; however, no matter what you do, there will be a time in most terminal illnesses when a patient feels no desire to eat.

The issue of nutrition is one of the most guilt-inducing, frustrating and emotionally charged issues affecting patients and families. Please discuss concerns with your HPCG nurse and social worker.

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

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