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For most of us, food is closely tied to life itself, but often appetite and food intake are lessened for the hospice patient.

In times of illness, food intake is especially important. Food provides energy and the building blocks needed to sustain strength. For most of us, food is closely tied to life itself, but often appetite and food intake are lessened for the hospice patient. There are many possible causes for this loss of appetite.

How to Help

  • Do not force the patient to eat or constantly remind them of their decreased appetite. Although an encouraging, gentle approach may help, the choice to eat is the patient's.

  • Serve the meal in a relatively comfortable, bright atmosphere. When feasible, eat in the room with the patient. Remove unpleasant odors and do not do unpleasant procedures around mealtime.

  • Have the patient take a vitamin tablet each day to help meet their vitamin needs.

  • Give mouth care prior to meals to freshen the mouth and stimulate taste buds.

  • Appetite tends to decrease as the day goes on; make the most of breakfast time.

  • Give pain medicines on a schedule to reduce discomfort before and during meals. For example, give pain medicine one-half hour prior to mealtime.

  • Allow the patient to rest after meals, but keep the head of teh bed elevated to promote digestion.

  • Adjustments to the diet may have to be made if the patients can no longer wear their dentures. Soft foods or small bite-sized portions of meat, softened with gravy are recommended.

  • If nausea is a problem, your primary nurse can talk to the doctor about ordering a medication to be given before meals to reduce nausea.

  • Add small pieces of cooked meat to canned soup or casseroles to improve nutrient value in foods.

  • Try new spices and flavorings for foods. It is common for a person's preferences to change during illness. Add sauces and gravies to dry food.

  • Try small frequent meals and leave a high protein snack or drink at the patient's bedside. Your primary nurse can give you information and recipes for high protein supplements.

Fluids/ Liquids

Liquids are also important for the body. They're necessary to keep skin and mucous membranes moist and to promote the removal of the body's waste products in teh urine.

How to Help:

  • Don't force liquids on the patient. A soft, encouraging approach is more effective; it's the patient's choice.

  • Encourage intake of quality liquids as weel as quantity, high calorie, high protein liquids provide both fluids and nutrition.

  • Prune juice and fruit nectars not only provide calories but also help to maintain bowel function.

  • Avoid liquids during mealtim. They may create an early sense of fullness.

  • Make "double strength" milk by adding non-fat dry milk to whole milk. Blend well and chill.

  • Use "double strength" milk instead of water for cooking cereals, diluting canned creamed soups, mixing puddings, and making instant cocoa.

  • Soda straws, spoons, or medicine droppers can be used to give liquids to patient's who are weak or unable to hold up a cup.

  • Give liquids in other forms, such as jellos, puddings, and ice cream.


Tube Feedings

Sometmiies a patient is unable to take food or medications by mouth. In some cases, nourshment can be given via a tube placed through the nose, down into the stomach, or directly through the skin into the stomach. Your primary nurse will teach you how to give tube feedings.

Things to Remember About Tube Feedings:

  • Give the feedings at room temperature.

  • Flush the tube before and after each feeding as directed.

  • Change the tape and clean the skin around the tube each day. Your nurse will teach you how to change the dressing.

  • Do not force food or medicine through the tube. If you meet resistance, attempt to flush the tube with water. Let your primary nurse know if you are unable to flush the tube.

  • Before giving each feeding, you must check to see that the tube is still in the stomach.

  • During feeding, as well as one hour after, the patient should stay in the sitting position.

  • If the tube comes out, don't panic. Call your primary nurse and she will replace it.

  • A patient receiving tube feedings should continue to receive mouth care.


As the patient's condition worsens, they will be taking in less food and liquids. This is usually more upsetting to the family than the patient who is no longer willing or able to continue to eat and drink. Trying to force a patient to eat will only cause conflict. It is a natural part of dying to begin to lose the desire to eat. Often a withdrawal from eating brings new awareness to the family of the patient's worsening condition and impending death. It is important for you to discuss your feelings about this with members of the hospice team, so you can continue to be supportive of the patient's right to choose, rather than acting angry or disappointed.

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