Why Hospice Patients May Not Be Encouraged to Eat Near the End of Life

When my mother was on hospice, we were told not to encourage her to eat. It’s the body’s natural response to shut down near the end of life.

Understanding the Natural Process

As the body approaches death, it naturally shuts down, including hunger and digestion. It is important to recognize that when someone is near the end of their life, appetite may decrease or even disappear. This is a sign that the body is preparing for the end, and forcefully encouraging eating will not be helpful and may make the dying person feel worse. People who still want food are those who are not close to death.

The Role of Hospice Care

Hospice care aims to help terminally ill individuals pass quickly and painlessly. This includes not forcing food, as it can create unnecessary stress for the dying person. Hospice focuses on ensuring comfort and quality time. When my father passed away from cancer, he ceased to eat just before his death. The hospice staff explained the natural process, and it was clear that forcing food would not be in his best interest.

Biological Mechanisms at Play

As the body prepares to leave this world, vital systems start to slow down, including the gastrointestinal tract, liver, and kidneys. This slowdown means that movement of the esophagus, stomach, and intestines (peristalsis) decreases, causing food to stay in the body rather than being properly processed. This can lead to discomfort and complications such as bloating, gas, and pain. Reducing fluid and food intake can help alleviate such issues and improve comfort.

Comfort and Symptoms Management

Dying individuals often do not experience hunger or thirst, as medical studies suggest. In my experience, almost no one reported feeling hungry or thirsty before passing away. Therefore, limiting food and fluids is about providing comfort. This involves addressing symptoms like edema, which is the buildup of excess fluid in tissues due to the body’s inability to produce sufficient proteins. Limiting water and food can help manage this condition and make the person more comfortable.

Conclusion

The practice of not encouraging hospice patients to eat near the end of life is not cruel and does not hasten death. It is a natural part of the body’s process of shutting down. It is crucial to remember that comfort is the primary goal of hospice care, and addressing the unique needs of a dying person can greatly improve their quality of life during what is likely one of the most challenging times. Understanding the biological and psychological reasons behind this practice can help families and caregivers better support those they love.