When someone we love isn’t feeling well, we often want to feed them to help them feel better, strengthen them, and show them that we care.

 

When a person is nearing end of life, they may not be eating as much as they once did. They may not want those foods that used to be their favorite. This is a normal process. It’s thoughtful and kind to offer them their favorite meal or encourage them to eat something nutritious, but don’t be upset if they decline the offer or only take a few bites.

 

At end of life, our energy is limited.

 

It takes energy to have conversations, to chew, swallow, and digest our foods, to get up to go to the bathroom, and even just to stay awake for an extended period of time. When just laying there doing nothing, the body still has to perform it’s normal functions, putting a lot of energy into things that we, as healthy people, don’t even consider.

 

During this process, the body is working extra hard, like running a marathon on the inside, just to keep up with the basic needs of life.

 

The heart and circulatory system tries hard to keep up and you may notice some of those changes. Pulses may be bounding or weak and may lead to edema, or excess fluid retention. The lung functions may be diminished, leaving the person unable to tolerate certain activities or experience shortness of breath.

Additionally, digestion and processing of food and fluids also takes a lot of energy. The digestive system slows and weakens and absorption can decrease. This can lead to changes with appetite or ability to eat, as well as urinary and bowel changes. When someone is drawing near to the end of their journey, their body may be more focused on those vital functions of keeping their heart beating and their lungs breathing than it is concerned with the nutrition they may receive from a few bites of food.

 

Our bodies were made to go through this. 

Just as the body was perfectly made to endure the process of being born, the body was also made to endure a natural death. Many studies show that when one is nearing end of life and not eating, the person experiences a sense of euphoria and calmness which helps to have a more peaceful departure from this life.

 

While going through the end of life process, the person may experience changes with their appetite, swallowing, digestion, and weight loss. As hard as it is to understand, they are not starving. Their body is preparing them for the journey, just as it was meant to.

 

Many caregivers have a hard time with this concept. They want to push their loved one to eat, holding on to the feelings that if they would only eat a nutritious meal, they would be stronger and stay with us a little while longer. Or if they would get IV fluids instead, that would keep them hydrated enough to prolong the inevitable.

It can be an emotional period. We have been taught to love people through food. At every big moment in our lives, like birthdays, holidays, weddings, etc, we show people we care by preparing food and celebrating. If someone has a flu or a cold, we make them some soup. A new neighbor moves into the area, we bring them a welcome dish! We’ve built a strong connection between food and love, but this time, it’s different.

So what do we do when someone won’t eat or drink? Many families want to start IV fluids or IV nutrition. What they don’t realize is that forcing their loved one’s body to take on those extra fluids, can cause unintended consequences.

 

Their system is slowing. Their ability to process the food or fluids is diminished. So when we start pumping a dying person with fluids, their body simply cannot keep up with the demand it takes to use those fluids properly and expel them as a waste product.

What happens when you force food or fluids?

They may become nauseated, have abdominal pain or bloating, vomiting, diarrhea, or constipation. They can also start having a build up of fluids within their body.

Administering IV fluids when their body cannot keep up, may cause excess swelling in the tissues or fluid on the lungs which, in turn, could cause increased shortness of breath, congestion, and discomfort.

If they have impaired swallowing and are not showing interest in foods, but we are still trying to feed them water with syringes, bottle caps, spoons, or pipeting it into their mouth with a straw, they could choke, cough, aspirate, become congested, and short of breath.

 

While we want to keep our loved ones around as long as possible and show them that we care by offering them their favorite foods or drinks, please keep these things in mind.

 

It is ok to offer, if they are willing and able, but do not force them or guilt trip them, their body may not be able to handle it