Everything You Know About Food Changes at End-of-Life

An apple a day..

“Eat your vegetables!”

Love at first bite.

Life is uncertain, eat dessert first.

You are what you eat.

Ever think about how much of our life is obsessed with food? That’s not a bad thing, as obviously we need to eat to live, and proper nutrition is important. Beyond that, food gives us pleasure and is wrapped around may of our fun times. Eating out at a restaurant, sharing a pizza with friends and roasting marshmallows over a campfire–all involve both food and the world around us. Friends, relationships and food.

Little wonder, when we are faced with end-of-life of a loved one, the idea that we need food is hard to shake. “But he needs to eat!”

No, he doesn’t. But the finality of that is so…final.

Comfort food

Your elder may have trouble chewing and swallowing, and their diet may be change to minced, where everything is chopped fine and certain drier foods are eliminated. Or, the doctor may say they need pureed food, where everything is made into thick liquids. Regular fluids are thickened to make swallowing easier.

This isn’t end-of-life, but an indication of the direction you are heading. Often, elders eat less and less and family members worry. As difficult as it is, this is a time to begin letting go. 

When my husband was dying of heart disease, I saw his appetite dwindle. I’d seen this many times but he wasn’t elderly at 55, so I missed the signs. I struggled to make something, anything which would appeal to him. It was a losing battle. He apologized for only eating a few bites and I struggled to pretend that it didn’t matter as I watched the weight drop off him. 

In the middle of this time, even after the doctor has declared end-of-life, it can happen. One elder asked for chocolate ice cream. He only took a few bites, but it gave him intense pleasure. I cooked a lobster for my husband and he savoured every bite. It was probably the last full meal he ate.

Food and drink becomes something different during end-of-life. No longer for nutrition, it can bring comfort if desired. Try not to stress if your elder isn’t eating, but be there with a favourite treat if they ask for it.

Often, as part of the body’s slow shut down, an elder loses the ability to swallow. This can be frightening and stressful for a care partner and they may think, “What about a feeding tube?”

Reasons not to consider a feeding tube for your end-of-life elder

  • Artificial nutrition and hydration was never intended for end-of-life elders, but to help those with temporary conditions from which they are going to recover.
  • When an elder at end-of-life can no longer swallow, their situation is not going to improve and there will never be a time when the tube is no longer needed.
  • The tube must be surgically inserted and can come out and need re-insertion in hospital.
  • Infection, issues with the tube (such as a blocked or broken tube) or the site, and diarrhea are all risks.
  • The question needs to be asked, “Is this quality of life?”

Is your elder able to have a conversation with you about their wishes? As difficult as it is, don’t put it off. Knowing how they would like end-of-life to look may be the best gift they could give you.

And honouring their wishes will be your best gift to them.

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Everything you know about food changes at end-of-life

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