Managing eating and drinking towards the end of life

Managing eating and drinking towards the end of life

This guide is designed to help reassure and give advice around eating and drinking towards the end of life. It describes some of the changes that can take place, however every person is different, so if you have any questions about what is happening and why, please do ask one of our clinical team.

Our priority is to provide the right support to our patients and their carers, families and friends. We tailor our care to the specific needs of the person being cared for. Everyone involved is an important part of the caring team; your views should always be heard and where possible, acted upon. We will be able to respond to your worries around possible discomfort and distress.

Decreasing appetite

It is very common for a decline in appetite to happen as the body cannot digest food as it once did. Weight loss may happen no matter how much is eaten. Taste changes may occur and your loved one may only want fluids.

Help with eating

In addition to having little or no appetite, the person may not have the energy to eat.

Helpful tips:

  • offer small snacks throughout the day
  • ensure food is cut into small pieces so less effort is required
  • if chewing is difficult, offer textures that are softer and easy to chew or puree food
  • finger foods can help maintain a level of independence
  • they may find drinking easier than eating, offer sips of smoothies, soups, hot or cold drinks
  • allow time for the person to swallow
  • never force someone to eat and drink
  • if the person coughs or chokes frequently when eating and drinking, they may need to see a speech and language therapist for advice
  • make sure the person is sitting upright when eating.

Help with fluids

It is important to avoid dehydration as this can cause weakness, confusion and restlessness.

Helpful tips:

  • have fluids close at hand
  • offer frequent sips
  • use ice lollies to keep the mouth moist and fresh
  • try a spill free cup if lips no longer fit tightly around the rim of a glass. Be aware that it may be difficult to drink from a spout
  • your loved one may forget to swallow, if they allow, stroking the side of the throat may help to stimulate swallowing. You can also gently prompt the person to swallow, offer an empty spoon, or take a cup to their mouth without giving them more fluids. This will help to trigger their swallow
  • sometimes, thicker fluids can be easier to swallow e.g. smoothies or milkshakes. Ask a speech and language therapist for further advice with this
  • very cold or warm drinks may be easier to swallow.

End of life

When a loved one is approaching the end of life, the desire or need for food and drink lessens and typically their body will no longer be able to get the usual benefits from it. This can be hard for loved ones to accept and they often worry and wonder if the dying person is thirsty, hungry or suffering.

The disease process can alter the desire to eat, the interest in food and the ability to digest food. When a loved one is approaching the end of life, it is expected that they will eat and drink very little, may refuse all food and drink or may be unable to swallow well. It is thought that a natural analgesic (pain relieving) effect is produced by not eating and drinking near the end of life.

Eating and drinking less or not at all is usually due to one or many of the following: difficulties with swallowing, nausea, reduced appetite, little energy, less engagement, or decreasing consciousness.

Normal body functions are responding to the disease process and are slowing in preparation for death. This is natural and expected.

What can you do that will comfort?

Comfort can be given in lots of other ways:

  • spend time together by reminiscing; give your loved one a hand or foot massage, lie together, listen to music or just sit quietly.

People approaching death usually do not feel thirsty when their mouth is kept moist:

  • apply lip balm to the lips, moisten and clean the tongue, lips and mucous membranes in the mouth with a mouth sponge or very soft toothbrush
  • moisten the mouth as regularly as needed with water from a teaspoon. 

Our support

When a loved one is dying it is likely to be a very difficult time. It can be hard to know what to do, what to say and how to cope. Remember that we are always here to help and support you. Please do talk to your nurse, therapist or doctor about how you are feeling and any concerns you may have.

I have difficulty swallowing food or drink