Sharon S. Richardson Community Hospice - Sheboygan, WI

Why It's Okay for Your Loved One to Stop Eating and Drinking in Hospice

Understanding the clinical implications of giving food or fluids near death can reduce stress for families. DeAnna L. Looper RN, CHPN, CHPCA from Crossroads Hospice shares valuable insights in a recent article she has offered to share.

We associate food with comfort. Babies bond with their mothers while nursing or being fed a bottle. We give our loved ones chicken soup when they have a cold. Food is so important to our cultural celebrations. For generations, this is how we have shown our family and friends that we care about them.

As a 20 year hospice nurse, a common concern I hear from families is: “I don’t want mom to starve,” or “I really want to get some fluids into dad.” I completely understand their concern on several levels; personal, emotional, and clinical. While all of those levels are important, it is the clinical level that is the most easily misunderstood. I want to explain why it is not always best to feed and hydrate dying patients.

When the body is dying, it is no longer able to regulate fluid well. Fluid imbalances can arise, causing significant symptoms:

Edema, which is swelling, can occur in the feet, legs and hands. This can make it harder for the body to fight infections or heal wounds. But worse, it can cause swelling in the lungs. This is called “pulmonary edema.”

Pulmonary edema can cause distressing symptoms such as shortness of breath, coughing and even the inability to get enough oxygen into the blood, which is known as hypoxia.

Hypoxia can cause our loved ones to become discolored, confused, agitated and even combative.

Food can cause just as many problems. Forcing someone to eat can cause choking or aspiration. This is when the person “inhales” food or fluids into the lungs. This can be painful. It can cause many of the same symptoms such as shortness of breath and coughing. Feeding our loved ones at this time can cause a host of gastrointestinal problems.
This can be especially painful to a person who is in the process of dying. Think of how it feels to be bloated or nauseous when you are healthy. For a person who is dying, it is much worse.

But families should not worry that their loved one is starving and thirsty. The reason? Simply put, the body is amazing! It knows during the dying process to gradually eliminate the need for fluids and food. The body has begun to shut down and prepare for the end. Therefore, trying to make them eat or drink will not comfort them. It will actually make their symptoms much worse.

As hard as it may be for us, there may come a time when we need to find new ways to bring relaxation and serenity to our family members. Your hospice nurse can guide you on when it is time to stop offering food and fluids. Just remember, this is really the best way to show your loved one that you care.