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To eat or not to eat—That is the question for the patient on hospice

To eat or not to eat-that is the question in hospice care

by Terri Durkin, SLP and Maggie Vescovich, SLP

Many families are faced with a difficult decision: what to do when their loved one refuses to eat or drink?

Caregivers struggle with the thought of their loved one going hungry, or not being able to eat the way they used to. We all know that we have to eat and drink to live. All of us have a sense of satisfaction in watching our loved ones eat their favorite foods. Eating is one of life’s pleasures! We associate food with positive, happy times, like holidays and parties, or simply socializing over a family meal after a long day. However, when one is near the end of life, food can become the natural enemy. It may cause pain and discomfort because the body is slowing down and can no longer process food as easily. Forcing someone to eat and drink will not prolong life. This is where the input of a speech therapist (SLP), after evaluating your loved one’s ability to swallow, can provide guidance and teaching for appropriate nutritional support during this fragile time.

The speech therapist can be helpful in guiding the hard transition that many hospice patients may experience when changes in swallow function may necessitate diet modifications. The safest way to feed may involve offering soft or smooth textures in smaller amounts, possibly more frequently. Ice chips, water ice, and juices may be suggested, especially to assist with dry mouth. In some cases, tastes of favorite foods might be the answer. Speech therapists encourage their patients to eat and drink as long as it is possible. With this said, it is important to make eating a pleasurable experience for your loved one. Here are a few suggestions to consider:

  • Let your loved one tell you what and when they are in the mood to eat or drink.
  • Encourage them to savor the food, taking time to taste and smell. Emphasize that slow pace and small amounts are the best way to eat.
  • It is often said, “we eat with our eyes”. Appearance and aroma are important elements to consider. Add color to pureed foods by using a variety of seasonal vegetables. The speech therapist can suggest naturally pureed choices that may be appealing to your loved one.
  • Sit and make eye contact while your loved one eats. In between bites and sips, socialize.
  • Take your cue from your loved one. They know when they need to stop and rest.

We hope this information will provide solace and comfort to you, the caregiver, as your loved one’s eating and drinking preferences change while on hospice care.

Terri Durkin, SLP and Maggie Vescovich, SLP are speech therapists with Holy Redeemer Hospice

4 Comments Post a comment
  1. Once a person’s system starts to shut down, food & hydration can cause more discomfort than benefit to the patient. It’s difficult to the rest of us to wrap our minds around that concept but we must.

    February 11, 2013
    • Yes, thank you, your comments are well taken.

      February 12, 2013
  2. Ellen L #

    My mother passed away Sept 9, 2012. She was only in hospice at her home for 12 days. Her grand-daughter and 2 great-grandchildren lived over 400 miles away but they travelled to see my mom for a long Labor Day holiday.

    Less than 2 hours after they left and said their good-byes, my mom refused all of her medications. We think she kept up her routines so she could see them. She passed away 7 days after my niece and her family returned home.

    We offered her the Ensure-type products she had been drinking, water ice (Thank goodness for Rita’s!), baby food – whatever she would say yes too.

    Yes, it is hard to watch a person refuse to eat or drink but I understood the reasons.

    It’s funny that I never knew my mom could be so stubborn!

    She would accept the Ativan and Morphine, but only after telling her that it would make her more comfortable. If we tried to mosten her mouth with the sponge swab without the medication, she really clamped her mouth shut!

    Because of the morphine and lack of fluids, I always asked the Hospice nurse or aide to check to make sure she wasn’t in pain or constipated. Thankfully, she never was.

    I’m sorry if I strayed off the subject.

    Thank you for reading this.

    February 15, 2013
    • Terri Durkin #

      Thanks Ellen for sharing your Mother’s story. We all benefit from personal experiences.
      Terri Durkin, SLP

      February 18, 2013

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