She has to eat or she’ll starve to death.
If he would eat he could get stronger and keep fighting.
She is giving up.
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I fix the food he asks for but then he only takes a few bites. He won’t even try.
There has to be something we can do; it isn’t natural not to eat.
Can’t we make her eat?
If he doesn’t eat he is going to die. It’s like suicide. It’s like we are killing him.
How do you respond to family members focused on their loved one’s loss of appetite? What do you say when asked how to make a patient eat more?
Anyone who has taken care of oncology patients has faced this issue. Families/caregivers may approach the dilemma in a variety of ways—with hypervigilance, frustration, anxiety, even anger—but the point they make is the same: eating means life, and by extension, not eating means death. We must eat to stay alive.
Eating is linked to physical health but also to emotional health. We enjoy taking meals together; we celebrate major events with food: births, weddings, holidays, and other milestones. We prepare food for those we love. In Maslow’s hierarchy of needs, the bottom of the pyramid is physiologic needs of which eating is a significant part. Our relationship with eating is complex and only more so when someone has a terminal illness. That a lack of eating causes alarm is not surprising.
The question about poor food intake may occur at any time during the course of treatment but there are 2 significant transition points when the focus escalates: during active treatment when the incidence of nausea and anorexia is first encountered and at end of life (EOL) when the patient no longer has an appetite. Communication and education at these junctures is critical to avoid additional suffering for the patient and family.
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JOIN THE CONVERSATION How do you respond to family members focused on their loved one’s loss of appetite? What do you say when asked how to make a patient eat more?
Go to the bottom of the article to comment and share your thoughts about counseling patients and their family members in the final stages of life.
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