Since he isn’t listening I’m going to share with you:
With gradual dying from disease or old age, nutrition, what and how much you eat, is the key to quality of living.
Over a period of months with disease and years with old age eating habits and needs change.
Appetite diminishes, the desire to eat decreases, and nothing looks appealing or tastes good. While all this is happening the body’s need to eat, for nutrition, for energy, increases.
What becomes important isn’t how much you eat but what you eat—-three meals a day is too much. Six tiny snacks will work better for a while. Heavy meat and potatoes are too much while cheese and crackers, yogurt, and soups go down easier. Ice cream, malts, and smoothies are good all the time.
Ensure Complete or high protein, high calorie smoothies become vital to meal planning. Ensure Complete is the highest calorie (350) and protein supplement (30mg) I have found.
Part of my husband, Jack’s, rationale for not eating is that we are an overweight society and it is healthier to be thin. Therefore, he believes he is healthier having lost 20 pounds and he should keep losing weight. He is right, we are an overweight society, but as you have heard me say many times, taking care of someone as end of life approaches (disease or old age) is different than taking care of someone who is going to get better. There are new rules. Nutrition is one of the new rules.
The basic new rule regarding nutrition at end of life is to have a bit of reserve, “meat on your bones,” not a lot of excess weight but a bit of a cushion. That reserve can add to the quality of life for a bit ——-isn’t that a gift we would all like to have?
—— To all you Caregivers out there my wish for you is patience (notice it is the one with a “C”), a listener you can share with and others to help you. Thank you for being mine today.
Something More About... Living Your Best Until You Can't
For more on this subject, I suggest reading my booklet, A TIME TO LIFE: Living With a Life Threatening Illness. This booklet addresses issues of comfort, nutrition, and sleep as they relate to the palliative care patient. It provides guidance to help them live the best life they can within the confines of their body and disease. This booklet is part of the End of Life Guideline Series. Caregivers will be supported by my guidebook, By Your Side, A Guide for Caring for the Dying at Home. It is knowledge and support for providing care at home. It is written for the caregiver.
10 comments
My 87 year old mother is going through late stage Alzheimer’s…mostly bedridden and feeling chronic pain from osteoarthritis. She is losing her desire to eat, but the home health aid insists that she eat in order to get her pain medication, sometimes spoon feeding her. I am wondering if this is the best approach, or should we let my mother choose as she gets closer to the end of life?
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BK Books replied:
Hi Olga, my suggestion is to always offer food, just don’t force it. The HH aide should continue to try to feed your mom (whether pain medicine is involved or not). With dementia your mom may have “forgotten” how to feed herself but as long as she eats if you put food in her mouth I would continue to feed her. There may come a time when she just holds the food in her mouth, or starts choking on the food and that is the time you may not be able to feed her. Blessings to you and your mom. Barbara
Whether comfort food or to eat or not to eat….. the answer is for them to choose. But education is never a waste in letting them know the side effects of the possibilities of more pain, GI problems, muscle cramps, and more. Especially if they are not getting proper nutrients for assimilation and proper digestion. An age-old dilemma from birth to death. Sharing is caring!
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BK Books replied:
In the months before death, yes, tell the person the ramifications of not eating and “let them choose” BUT as death gets closer it is not about choosing. It becomes about they just can’t eat. The body is choosing not to have the nutrition, not the individual making a conscious choice. Always offer, don’t force. Blessings! Barbara
My mother is 92. She is short (4’11") but weighs only 83 lbs. If she is telling the truth. She is very thin. Way too thin. He entire life she has worried about being overweight. Now, she is weak and frail because she has not fat and very little muscle. I try to get her to eat more. I take her food and out to eat sometimes. But at home she only has coffee and toast with butter. What do you suggest? She will eat when food is in front of her. But refuses any home care. She lives alone. And she still takes laxatives and diuretics to stay thin
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BK Books replied:
Hi Roger, you can lead a horse to water as the saying goes. Living alone she is her own boss and you can’t make her eat. A suggestion, will she drink a protein supplement? Ensure Complete has 350 calories and 30 grams of protein which would help her non eating a lot, the more cans per day the better, comes in different flavors, generally at grocery stores or drug stores. It might be worth a try. You said she will eat if food is in front of her. What about Meals on Wheels? It is prepared food delivered to her door. Bottom line is she is independent, living alone and will live her life as she pleases even if her choices are not in her best interest. I know it creates a helpless feeling in you who sees a different picture of her future than she does. My blessings are with you both. Barbara
An excellent, insightful post, Barbara. Failure to thrive due to Parkinsons dysphagia led my loved one to choose hospice. It allowed him a beacon of joy to let go of his long struggle. He valued your writing, too.
Blessings for your work.
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BK Books replied:
Hi Deborah, I’m glad my materials were beneficial to you and your husband.
Blessings! Barbara
my brother sent me the podcast “Art of Manliness” that you were on – your work is AMAZING – I am not new to death as I have intimately lost 10-12 close friends and family – in a combination of at home and in hospital – all due to disease. My father is currently on hospice – but is dying of regular “old age” despite a litany of physical issues. Your description of the dying process has proven to be invaluable where his dying process in concerned. I cannot thank you enough – God Bless…
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BK Books replied:
Thank you Elizabeth. Blessings to you and your Dad. Barbara
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