When A Hospice Patient Stops Eating

What mattered more at Thanksgiving . . . the food or the people?

What mattered more at Thanksgiving . . . the food or the people?

Ever said a variation of these . . .

  • Want to get some coffee?
  • What are you bringing for Thanksgiving?
  • How about lunch next week?
  • Let’s get together for dinner and talk about it.
  • How about kicking back and ordering pizza tonight?
  • Did you hear about that new restaurant?

We are a food-oriented people. And rightly so!

Whether it’s last week’s fancy restaurant meal or thin gruel fed to Charles Dickens’ fictional orphans, food nourishes us. We have favorite food . . . my friend Juanita’s sock-it-to-me-cake is to die for. We have comfort food . . . please give me a good movie, a comfy couch, and then bring on the chips and salsa with cheddar cheese melted on top. We have memories of meals at great restaurants. We have stories about cheap meals on a date with the person who became our beloved. We munch on popcorn or peanuts and can’t stop grabbing one more handful. We love-love-love the food Mom made—potato salad or pineapple upside down cake or tuna fish sandwiches—that no one else in the world can duplicate. We swap family recipes, sneak junk food, try all the samples at Costco, and every once in a while we eat breakfast for dinner because . . . well, just because!

In hospice, one of the toughest times for an individual or a family caring for a loved one is when that person no longer wants to eat.

If they eat, they will get better. Isn’t that true?

If they take a few more spoonfuls of soup, they’ll live for another day. Isn’t that true?

They may not want to eat anything today, but tomorrow will be different. Isn’t that true?

Sometimes our dying loved ones can’t express their wishes. Often, we try to keep feeding her or him even when they resist or ignore the food. How could they not want to eat?

Sometimes our loved ones, who can speak and make decisions, indicate they aren’t interested in even a little custard or buttered toast. How could they not want food? We try to feed them.

While not the case with everyone in hospice care, some patients—your best friend or child—will say “no” to food. The mother who always made your special birthday cake doesn’t want to eat. The spouse who dared you to go to that Tex-Mex joint in the bad part of town that turned out to be the best meal of your life no longer wants any meal. In hospice, there will be a temptation to force someone to eat. There will be family arguments over how much (or how little) has been eaten by grandma. There will be skirmishes between sisters and brothers about what to do with Dad when he doesn’t touch the food on his plate.

This is hard.

This is impossibly hard.

For years, my mother described Dad’s health as stable because, “He ate three squares a day!” Even as his dementia worsened (along with other ailments), he knew exactly when the meals were served. After we moved Dad to a memory care facility, meals were one of the few highlights of his day. Mom would often visit the facility around lunch or dinner to eat with him. She’d also bring him grapes or homemade cookies for snacks. He slowly declined. He began to eat less. But she kept bringing snacks, kept showing up for meals.

How could she not?

How can any of us arrive at a point where we don’t want to offer the next taste of life to another?

If you reach a point where your loved one can’t eat or has lost interest in food, I urge you to talk to your hospice nurse. Maybe yesterday you argued or pleaded with the nurse about a wonder drug to prompt more eating, but today ask the nurse explain the changes to your loved one’s body. It will be an impossibly hard conversation, and it will take courage to truly listen. But if a time arrives to stop offering spoonfuls of pudding or sips of Ensure, maybe you can sit beside your spouse or parent or friend to offer the nourishment of your companionship.

And please, don’t think only offering companionship means you’ve “failed” or death has “won.”

drawing-hands-holding-hands-love-Favim.com-903785Tell me truthfully, when you had the overpriced pizza on that date with the one you fell in love with, or when you proposed marriage at a snazzy French bistro, or when you flew across the country for Thanksgiving with family . . . what mattered more: the food or the person?

Wasn’t the most important, from beginning to end, spending time with the people you loved?

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

 

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Comments

  1. Larry, once again you leave me in awe of your wisdom; thank you for sharing it. My parents died before hospice was widely available, so I my brother and I didn’t have this resource to help us. But thankfully, more than three decades later, hospice has become part of healthcare and we couldn’t have been more appreciative of the service of the organization we helped my cousins choose for their father – our uncle, my dad’s brother.

    Reading this week’s Hospice Matters reminded me so much of the time we spent with my uncle in his last weeks. Towards the end, he didn’t feel like eating much; his favorite foods didn’t appeal to him and he was content to take his medicine crushed in his applesauce. And that was his nutrition for the day.

    We were concerned, we were confused; we were scared. Watching him stop eating meant . . . well, I knew what it meant. But his children wanted him to eat, they thought that if he just ate maybe he’d . . .

    Thank you. Thank you for once again sharing the honest-to-God truth of the process of dying. And thank you for your insight into the idea of “the nourishment of [y]our companionship.”

    This one really hit home. Thank you…

    • Thanks for your thanks, Rusty!

      Oh how I wish others would find my site and read some of my thoughts. I mean, I’m not brilliant or new with any of my concerns/questions, but I know these can be crucial issues . . . as decisions are made about health care, about comfort vs. cure.

      I was aware, this week, of a family’s anguished arguments for/against feeding a loved one. I’m sure there will be another family with another debate next week at our hospice (and a thousand other hospices across the country). Sigh. As hard-hard-hard as it is, families need to openly share about what this means. Don’t wait to talk until the only feelings remaining are anger, dread, and fear.

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