End-of-Life Care: When to Stop Feeding a Hospice Patient

Witnessing the decline of a loved one due to a terminal illness can be one of life's most heartbreaking experiences. But it is especially painful when hospice patients stop eating and drinking. Food plays such an integral part in how we show love and care that when a loved one stops eating, it can be difficult to know what to do.

That’s why it can be disconcerting when hospice providers recommend stopping nutrition. But these decisions about when to stop feeding a hospice patient are based on what is best for the patient's dignity, health, and quality of life. Ending nutrition can make patients more comfortable, making it easier for them to pass away peacefully. By understanding why this recommendation may come up, families can better prepare themselves emotionally for the journey ahead.

Why hospice patients stop eating

As a hospice patient approaches the end of their life, it’s natural for them to become less interested in food and drink. This is all just part of the dying process; a dying patient’s nutritional needs are different. They need less nutrition and liquids because their body is shutting down, and their organs can't process food and water like a healthy person's can.

In these cases, withholding food and fluids does not cause any additional pain or suffering for the patient. In fact, forcing hospice patients to eat can cause distress and discomfort. As the body starts to shut down, it loses its ability to regulate fluid. This causes imbalances that result in complications like swelling, confusion, difficulty breathing, and even death.

Forcing someone to eat can also lead to choking or aspiration, which is when food or liquid enters the lungs. This is an uncomfortable (at best) experience for healthy people, but it's especially painful for someone who is dying.

When to stop nutrition at hospice

Hospice care never denies food and drink to a patient. If the patient still wants to eat or drink, they can. But it's important to use the body's decline as an indicator for when to stop feeding a hospice patient.

The best thing to do is to respect the body’s natural process and ensure that nutrition is stopped when it does more harm than good. This decision should be made with the help of a qualified hospice provider who can assess the patient's individual needs.

Hospice providers will typically recommend stopping food and fluids when it is clear that they can no longer be digested or tolerated by the patient. This includes instances in which a patient experiences symptoms like excessive vomiting and difficulty swallowing. The patient may also simply refuse food and drink – a decision that should be respected by caregivers.

When to stop tube feeding in hospice

In some cases, hospice providers may recommend a patient receive artificial nutrition and hydration (i.e., tube feeding). This can provide comfort for the patient, but it should always be discussed with their doctor first.

Once the decision is made to offer tube feeding, a time will come when it must be stopped. Some patients dislike the feeling of a tube in their mouth and want to stop using it. Other times, it becomes clear that the body can no longer use the nutrition or hydration provided. After this point, providing artificial nutrition becomes more of a burden than a benefit.

What to expect when a hospice patient stops eating and drinking

When the time comes to end nutrition, the patient will become weaker as their body continues its natural process of dying. Without food and water, hospice patients can die in as soon as a few hours to as long as a few weeks.

It is also expected that the patient can experience increased discomfort due to dehydration. Hospice providers will monitor the patient closely and provide comfort measures such as pain medications and other treatments designed to keep them comfortable. Additionally, family members should be informed of any changes so they can be prepared for what may come next.

How to provide comfort during this time

At this stage in their treatment, hospice patients need care that is focused on comfort and quality of life. Here are some ways you can provide comfort to your loved one:

• If the patient can still eat or drink, caregivers can offer patients tiny sips of water or other liquids, small amounts of food, ice chips, or hard candy. Remember to pay attention to their cues to see if they have had enough.
• Sometimes, doctors will allow "pleasure feeding" of favorite food items. Pleasure feeding in hospice is designed to provide enjoyment, not proper nutrition. After months or even years of a restricted diet, this can provide great comfort to the patient. To avoid choking, caregivers should take care to raise the head of the bed and feed the patient tiny bites.
• For patients who can no longer drink, you can moisten their mouth and lips with swabs, lip balm, or a damp washcloth.
• In cases when a hospice patient can no longer tolerate food or liquids, caregivers can still provide comfort in other ways. This includes massages, telling stories, playing their favorite music, or providing meaningful physical contact. Remember that even if a patient is no longer able to communicate verbally, they can still hear and feel the presence of loved ones in the room.

Where to get help

It can be difficult to accept when a loved one stops eating and drinking. But this is a natural part of the dying process and ending nutrition is not an act of cruelty or neglect. As long as the decision has been made with medical guidance, there is no need for guilt or worry. If you need help navigating these decisions, don’t hesitate to reach out to us at Guaranteed Hospice. Our team understands that the decision to stop nutrition can be emotionally taxing and can provide resources to help navigate this process.

With Guaranteed Hospice, you can be sure that your loved one's end-of-life care is in compassionate hands. Contact us today to learn more about how Guaranteed Hospice can support you and your loved ones.