When Your Dying Loved One Refuses Food

Join SevenPonds each month as Tani Bahti, RN, CT, CHPN, offers practical on-hand guidance to demystify the dying process. As an RN since 1976, Tani has been working to empower families and healthcare professionals to have the best end-of-life experience possible both through education and the development of helpful tools and resources. As the current Director of Pathways, Tani is also the author of “Dying to Know, Straight Talk About Death and Dying,” considered by SevenPonds to be one of the most practical books on the topic. Founder Suzette Sherman says this is, “the book I will have at the bedside of my dying parents some day, hopefully a very long time from now.”

Just 4 more bites of applesauce…please. You have to eat something!

It’s not easy watching your loved one lose weight due to the loss of appetite that accompanies advancing disease. This is one of the most emotionally charged issues with terminal illness, so it’s important to understand how the body changes over time.

Sometimes the causes of loss of appetite are reversible and should certainly be tended to. Those reasons can include nausea, pain, cognitive changes, mouth sores, constipation, depression and the like. Of course, we want to treat that. No one should be deprived of the joy of eating when the barrier is fixable. But there will come a time when we cannot reverse the course. It’s this time that creates fear and conflict.

Because we associate the provision of food with health, nurturing and assuring an energy supply, it may feel like we’re failing to provide good care when our loved one is refusing to eat and losing weight. You may fear they will starve to death.

In fact, you are providing the best care when you let your loved one refuse food that may be causing more problems than it is relieving.

You are promoting comfort and honoring the changes that are occurring rather than forcing food that the body can no longer process. Let’s look at why this is true.

Depending on the illness, the loss of appetite can begin days, weeks and even years before death. The body’s need for food decreases over time. The ability to process food slows down. If you force food when the body says “No,” you can cause discomfort, such as cramps or nausea. In the case of some advanced cancers, you actually may be feeding the cancer cells, promoting their growth, rather than providing the hope for nourishment.

The body is wise. When a person is not eating, a process called ketosis occurs, which in turn releases endorphins that enhance a sense of well-being. If we force feed, that comforting process is reversed.

Listen to what your loved one is saying. No coercion to eat. No guilt for either of you if food is turned down. By honoring the wisdom of the body, you are promoting the comfort you seek.

Focus on feeding the spirit rather than the body with a warm touch, a smile, a shared laugh or singing a favorite song.

While four more bites of applesauce won’t change what is happening to or nourish the dying person’s body, four more hugs may be the perfect prescription to nourish their spirit.

And yours.

Take a look at a copy of Tani’s book “Dying to Know, Straight talk about Death and Dying” to help demystify the process and offer words of wisdom on the many aspects of dying.