Managing nutrition symptoms at end of life is an important part of helping someone remain as comfortable as possible. As a person approaches the end of life, they may experience changes in appetite, digestion, taste, and their ability to eat and drink comfortably.
In Episode 27 of The Geriatric Dietitian Podcast, we’re continuing our five-part series on end-of-life nutrition by discussing common nutrition-related symptoms and strategies that may help.
This episode is based on my article, End of Life Nutrition: What Everyone Needs to Know.
Nutrition Care Changes at End of Life
One important thing to understand is that nutrition care looks different depending on where someone is in the end-of-life process.
Someone who has months remaining may have different nutrition needs and goals than someone who is actively dying. There may be opportunities to manage symptoms, improve intake, and support quality of life. But as someone approaches the final days and hours, the focus shifts increasingly toward comfort.
That’s why nutrition recommendations should be individualized and discussed with the healthcare or hospice team.
Managing Poor Appetite at End of Life
Poor appetite is one of the most common nutrition-related concerns at end of life. When someone is still interested in eating, there are strategies that may help support their intake.
In this episode, I discuss offering small, frequent meals and snacks instead of expecting someone to eat large meals. I also talk about offering favorite foods and considering higher-calorie options when appropriate.
The goal is to make eating easier and more enjoyable rather than creating pressure around how much someone eats. As someone gets closer to actively dying, their appetite may continue to decrease, and that’s an important part of the process to understand.
Managing Dry Mouth and Mouth Pain
Dry mouth can be uncomfortable, especially when someone is eating and drinking less. Providing good mouth care is one of the ways caregivers can help promote comfort.
In this episode, I discuss options such as ice chips, lip balm, and moistened oral swabs. Mouth pain can also make eating uncomfortable. Depending on the person’s symptoms and ability to eat safely, softer foods and adjustments to food texture may be helpful.
The important thing is to pay attention to the person’s comfort and what they can tolerate.
Constipation and Diarrhea at End of Life
Digestive symptoms can also affect comfort and quality of life. Constipation may be associated with changes in food and fluid intake, medications, and reduced activity.
In this episode, I discuss nutrition considerations for constipation, including fiber and fluid intake when appropriate.
Diarrhea is another symptom that can be uncomfortable and may require adjustments to nutrition care.
These symptoms need to be evaluated in the context of the person’s medical condition, medications, and stage of illness.
Managing Nausea and Vomiting
Nausea and vomiting can make eating difficult and may contribute to reduced food intake.
In this episode, I discuss nutrition strategies that may help someone tolerate food more comfortably. It’s important to pay attention to the foods a person tolerates and avoid creating additional discomfort by pressuring them to eat.
For persistent symptoms, working with the healthcare or hospice team is especially important.
Changes in Taste and Smell
Food preferences can change as someone approaches the end of life. Foods that once tasted good may no longer be appealing, and medications or illness can affect how foods taste and smell.
This is why I encourage caregivers to ask what the person actually wants to eat. Rather than assuming that someone’s favorite foods will always stay the same, we can pay attention to their current preferences.
Food should be something that provides enjoyment and comfort whenever possible.
Nutrition and Pressure Injuries
The final nutrition-related concern I discuss in this episode is pressure injuries, sometimes called bedsores. These can develop when someone is spending significant amounts of time sitting or lying in bed. Care strategies may include cushioning, repositioning, and specialized mattresses.
From a nutrition standpoint, protein, vitamins, and minerals play important roles in maintaining skin health and supporting tissue repair. However, nutrition recommendations still need to be considered in the context of the person’s overall condition and goals of care.
Supporting Comfort Through Nutrition
Managing nutrition symptoms at end of life is about understanding the person’s individual needs.
Not every intervention will be appropriate for every person, and nutrition goals may change as someone moves closer to death.
My hope is that this episode helps caregivers and healthcare professionals recognize common nutrition-related symptoms and consider ways to improve comfort.
In our final episode of the series, we’re going to bring everything together with my Food Rules at End of Life.
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