When Food is Not the Answer

Please sir, more

“Please, sir,” replied Oliver, “I want some more.”

How often have you asked a variation of these:

  • Want to get some coffee?
  • What are you taking to the potluck?
  • Do you have time for lunch next week?
  • Can we get together for dinner and talk about it?
  • How about kicking back and ordering pizza tonight?
  • When are we going to that new restaurant?

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

Whether it’s a romantic restaurant meal that became a turning point in your relationship or the thin gruel fed to Charles Dickens’ fictional orphans, food nourishes us. We have favorite food linked to memories, like my pal Juanita’s Sock-It-To-Me cake from long-ago birthdays. Please give me a good movie, a comfy couch, and then add the chips and salsa with cheddar cheese melted on top. Years later, friends can recall meals at great restaurants. We have stories about cheap meals on a date with the person we married. We munch on popcorn or peanuts and can’t stop grabbing one more handful. We have that comfort food Mom made—for me it was potato salad, ranger cookies, or fried chicken—that no one else in the world can duplicate. We swap family recipes, sneak junk food, taste the sample “snacks” at Costco, and on rare, fun occasions 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 another spoonful 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 taste of pudding or a bite of buttered toast. How could they not want food? We try to feed them, scheming to overcome their resistance.

While not the case with everyone in hospice care, there are patients who bluntly refuse 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 even a bite. In hospice, there will be a temptation to force someone to eat. There will be arguments between loved ones 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. She kept showing up for meals.

How could she not?

How can any of us not 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 to explain the changes to your loved one’s body. It will be a difficult conversation, and it will take courage to truly listen. But if a time arrives to stop offering a spoonful of soup 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.”

Tell me truthfully, when you had the cheap pizza on that date with the one you fell in love with or when you proposed marriage at a pricey French bistro or when you flew across the country for Thanksgiving with family . . . what mattered more: the meal or the moment; the pasta or the person; the dessert or the delightful conversation?

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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  1. How do you stop one from offerring and constantly baggering about eating because “it will make you well”? Can I ask my mother’s hospice nurse to talk to my step-father about it or is there someone else? I would just like my mother to die in peace. He thinks he is helping her and I am not so sure.


    • Essie:

      I encourage you to talk with the nurse so that he or she can explain some of the reasons your mother should not, or can’t, eat. Along with getting some help from the nurse, if your step-father relates well to any other hospice staff (a home health aide or social worker), maybe they could join in the conversation.

      When someone can’t eat, doesn’t want to eat, refuses to eat, or shouldn’t eat . . . it’s often so difficult for a caregiver to accept this. I hope your mother’s nurse will be able to help your step-father understand.

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