Nutrition at the End of Life
When a seriously ill family member or friend does not eat, it can be very distressing. However, it is important to remember that a progressive loss of appetite is a common part of the dying process. As the body’s systems slow, the need for caloric intake diminishes. Food that has fueled healing in the past may now bring about discomfort and possibly pain. Eating and drinking no longer bring pleasure and renewed energy. Foods do not taste right.
During the dying process, there are several changes that the body goes through that may indicate a need for less calories. The body systems slow and ultimately stop working, requiring less calories. Cells no longer repair or replace themselves. Intracellular fluids are recycled by the body and hunger ceases.
Think about how much work it is for the body to process food. The ability to digest food and to maintain the proper balance of fluid is lost as the body shuts down. Lack of interest in eating and drinking may be a way for the body to protect itself from taking in something that could cause distress.
Because of these physiological changes, most terminal patients have anorexia or cachexia. Over 80 percent of terminal patients have anorexia, or a loss of appetite and most develop cachexia, which is the loss of weight, muscle atrophy, fatigue, weakness and significant loss of appetite in someone who is not actively trying to lose weight. Cachexia cannot be reversed nutritionally; even if the number of calories consumed increased, the terminally ill person will continue to lose weight.
The body’s natural slow down is a normal process, and is not painful. Many people just do not have an appetite. They may only want sips or bites of food, or nothing at all.
At Arbor Hospice, dieticians assist patients in attaining the best nutritional intake possible given the current state of his or her health. Working with the physician, dieticians will propose alternative ideas for food types that are more appetizing to the patient or ways of preparing or serving the food that make it possible for the patient to eat. In addition, this nutrition section will help those at the end of life, and their caregivers understand the body's natural processes at the end of life.