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Loss of Appetite

Loss of Appetite

When your loved one can no longer eat a meal, you may feel that you have somehow failed to provide loving care. Nothing could be further from the truth. A patient’s loss of appetite is the most commonly-reported concern of caregivers, but it is not a common complaint of terminally-ill patients. Hospice patients often have decreased appetite. You can provide comfort care by giving your loved one any food or drink he or she desires. Do not force-feed or make your loved one feel they need to eat to please you. 

Loss of Appetite: Possible Causes

How You Can Help

Progression of the serious illness

Talk to your hospice team nurse to learn how your loved one’s illness can affect his or her appetite.

The illness, medications and treatments can cause your loved one to change his or her eating habits and preferences. 

Alter seasonings or sweeten foods with sugar or honey to adapt to taste changes. Try new foods/recipes if your loved one is willing.

Nausea

See tips under “Nausea.” 

Smell of food, odors and fragrances

Reduce odors whenever possible.  Circulate air with open windows or fans.

Constipation

See tips under “Constipation.” 

Diarrhea

See tips under “Diarrhea” 

Dry mouth

For relief, offer your loved one sips of water, hard candy, popsicles or ice chips.

Mouth sores

Talk to your hospice team nurse.

Difficulty chewing and swallowing

Modify food and liquid textures to meet the patient’s needs.  Try soft foods or blending nutrient-rich shakes.

Tooth or denture discomfort

If your loved one has lost weight, his or her dentures may no longer fit properly.  If this happens, try to have a dentist refit the dentures. If this is not possible, leave the dentures out.

Abdominal distention, bowel blockage

Talk to your hospice team nurse.

Medication

Talk to your hospice team about medications to manage the potential side effects caused by prescriptions.

Difficulty breathing

Talk to your hospice team nurse.

Anxiety, emotional pain, stress

Talk to your hospice team; they can offer both experience and understanding.  Our social workers and chaplains can counsel you and your loved one through this difficult time.

Physical pain

Your hospice team can offer expert pain management strategies which may be new to you and your loved one.  Be sure to discuss your concerns with your doctor and your hospice team nurse.

Other Ideas

  • Offer small, frequent meals rather than large meals.

  • Serve meals when your loved one is most likely to be free of pain and has the most energy.

  • Your loved one’s favorite foods will likely give him or her the most comfort. Bread pudding, homemade soup or a cup of cocoa may give emotional comfort even if your loved one wants only one bite.

  • Prevent early feelings of fullness by serving beverages between meals, not with meals.Avoid carbonated beverages.

  • Create a relaxed atmosphere without pressure to eat.

  • Put the emphasis on enjoyment, not eating, by combining the meal with the company of friends, a favorite movie or other pleasurable activities.

  • Music, like food, can bring back happy memories, moods or emotions.

  • Make sure your loved one is comfortable.Keep the room cool.Moisten dry lips with Vaseline. Keep hair and bedclothes clean.

  • Creatively customize recipes.

  • Offer your loved one new and unusual flavors, if his or her tastes are changing.

  • Use easy-to-handle, attractive dishware, flatware, glasses or colorful disposables.

  • Use bendable straws, and cut the straw in half if drawing liquids is difficult.

To keep your loved one comfortable, treat the whole person, not just the symptom:

  • Keep the room cool.

  • If diarrhea has left your loved one’s rectal area sore or irritated, ask your hospice aide for lotions or ointments that can help.

  • Provide a relaxing environment with music, lighting and quiet pastimes.

  • Provide easy access to a toilet, commode or bedpan.

  • Place a waterproof pad under the patient, in case of accidental leaks.

Consider the following factors when making decisions regarding your loved one’s nutrition:

Patient wishes – Can meals be easily tailored to meet your loved one’s needs and desires?  Does he or she want an IV or tube, even though it may cause discomfort?  Be sure your actions follow any wishes laid out in your loved one’s advance directives.

Prognosis – Where is your loved one on his or her end-of-life journey?  Will he or she have better quality of life if aggressive nutrition/fluids were given?

Family wishes – Are you and/or other family caregivers willing to manage home nutrition support?  Do you understand that aggressive nutrition support may not improve your loved one’s condition?  Do you understand how to give “comfort care” which honors your loved one’s wishes and beliefs but does not force feed him or her?