Food and Fluid Issues at the End of Life

Patient & Family Teaching Sheet

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What are nutrition and hydration?

  • Nutrition (food) is the intake of calories to support the body.
  • Hydration (fluids) is the intake of fluids to support the body.

The desire to eat or drink at the end of life usually decreases. This is a natural response to the body as the organs are slowing down, and it becomes difficult to manage the intake of food and/or fluids.

What to Report to the Care Team?

Tell them if the person:

● Is unable to eat or drink
● Has trouble swallowing
● Has a dry mouth, tongue, or skin
● Loses more than five pounds in a week. You may notice the weight loss by loose fitting clothes or dentures
● Makes less urine
● Becomes confused or drowsy

What Can Be Done?

If there is a problem that can be managed, your healthcare team will discuss possible treatment options. It is normal for the person to lose interest in food and drink as the illness progresses. Treatment choices will depend on the person’s wishes and illness.

Things you can do

● Encourage favorite foods and drinks; never force a person to eat or drink
● Help family members and friends understand why eating and drinking may make the person uncomfortable as the body loses the ability to use nutrition and hydration
● Offer drinks or sips often – at least every two hours
● Clean the mouth often – a pleasant-tasting mouth may make food taste better
● Support the person’s decision if he/she refuses food and/or fluids
● Encourage the person to rest before and after a meal
● If dentures do not fit well, consult a dentist
● Make mealtime a quiet and pleasant time
● Offer small meals and use smaller dishes
● If nausea is a problem, serve small portions of salty (not sweet), dry foods and clear liquids
● Find other ways besides food and drink to show care and support. For example, offer the person a massage, apply lotion to his or her hands or feet, look through a picture album together