Food for Thought at the End of Life

From our first moments in this life, food plays a central role. Food evokes feelings and memories. Cultures around the world celebrate holidays and important life events with specific dishes. Most people can instantly name their favourite foods, and for many of us, making someone their special meal is an act of love. Food is comfort. Food is survival. Food is health. Food is strength. Food is a love language.

Photo from Wix.

When someone is diagnosed with a life-limiting illness, their physical relationship with food can change. Meals that used to be favourites can now be problematic. As illness changes the body, a person may not be able to eat their normal portions.

These physical changes have a psychological impact - not only on the person who’s ill, but on their loved ones and caregivers, too. It can be one of the first sources of anticipatory grief as both the person and their circle adjust to the new normal that the disease progression prescribes.

The person in palliative care can feel obligated to try to eat the foods their caregivers have lovingly prepared. Caregivers can feel deflated, anxious, and defeated when their favourite dishes are left untouched.  All parties can feel like failures. It’s an emotional soup that adds stress to an already heartbreaking reality.

And at the end of life, as the body starts shutting down, the situation compounds as appetite fades and food intake stops. It is ofen quite difficult for caregivers to give up on feeding their person. They worry that without food, their loved one won’t have the nutrition they need to stay strong. They worry that death could be hastened because their loved one isn’t eating anymore. If they’ve always expressed their love and care through food, giving that up is difficult.

Part of the support and guidance the palliative care team can provide is sensitively educating caregivers on the wisdom of the body. Helping them understand that by not eating, their person is following a natural end-of-life progression where food is no longer needed - or wanted - by the body. In fact, eating when the body can no longer digest food could actually cause harm and discomfort.

The palliative team can help caregivers stay connected and express their love through other means - touch, talking, singing, and reading favourite books aloud are a few suggestions. Love can be expressed in many languages besides food; those supporting people and their circle at the end of life can help them find the translation that fits best for them.

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Mary Cassidy is a retired veterinary hospital manager and veteran learning and development professional. Mary is a graduate of HHA's Death Doula Certificate Program and volunteers as a Home Hospice Visitor with Acclaim Health and at Ian Anderson House hospice in Oakville, ON.