Eating and appetite near the end of life
As a person nears the end of their life they often stop eating. Other times, it becomes unsafe for the person to consume solid food, or even liquids.
At times, family members become concerned, and urge or pressure the person to eat and drink. In these circumstances, we discuss the situation with the family members and share the following information with them in writing.
Eating and Appetite near the End of Life
Totally Stopping Food Intake
From Gone From My Sight, The Dying Experience, by Barbara Karnes RN — Changes Beginning One to Three Months Prior to Death
Food is the way we energize our body. It is the means by which we keep our body going, moving, alive. We eat to live. When a body is preparing to die, it is perfectly natural that eating should stop. This is one of the hardest concepts for a family to accept. (Emphasis added)
There is a gradual decrease in eating habits. Nothing tastes good. Cravings come and go. Liquids are preferred to solids. “I just don’t feel like eating.” Meats are the first to go, followed by vegetables and other hard to digest foods, until even soft foods are no longer eaten.
It is okay not to eat. . . .
Difficulty Swallowing and Aspiration Precautions
Difficulty swallowing (dysphagia) is a symptom that occurs in many people with serious life-limiting illnesses. A person suffering from dysphagia is at risk of having food, saliva, liquids or vomit enter into their airways or lungs. This is known as aspiration. Dysphagia can lead to distress, choking, pain, regurgitation and total inability to swallow or even aspiration pneumonia.
If a patient is suffering from dysphagia the medical/hospice team will order aspiration precautions for the safety of the patient. These precautions could prohibit food and/or liquid consumption, or could restrict intake to thickened liquids and pureed foods.
Circumstances where food intake is not appropriate include
- Patient or resident prefers not to eat or drink.
- Inability to swallow (dysphagia, see above) and medically-ordered aspiration precautions.
- Bowel obstruction and blockage – taking in food can lead to vomiting, swelling, discomfort and pain.