As families watch over aging loved ones, they may witness their elders starting to refuse to eat. The aging parent seems less and less interested in food. As we usually think of food as very important to maintain energy, it’s a matter of concern when they won’t eat. Should you do something about this?
Loving families try various things to push nutrition on the aging parent. Urging, even scolding are common. Sometimes the aging parent will comply, in effort to please the caregiver, or to just stop them from the “pestering” they feel. If you are in this situation, consider where your loved one may be in their life cycle.
If your aging loved one is reasonably healthy and is having a temporary setback with appetite due to a surgical procedure, illness, or new medication, the appetite will likely improve over time, as the body adjusts. But if your aging parent is getting closer to the end of the life cycle, and you are willing to see this truth, it makes less sense to try to get the elder to eat. According to Today’s Geriatric Medicine, “Diminished Appetite at End of Life”, (July/August, 2022), by Scott Janssen, loss of appetite is expected as people near end of life. It is very common then and in the context of serious illness.
With terminal illness, including end-stage dementia, the body is in process of shutting down. The body does not need food to do this. Digestion slows, and the person’s ability to metabolize food is disappearing. This is hard for caregivers to accept. We associate giving food with love and eating food with gaining strength. At these times when the body is going through it’s natural course of decline, food no longer has the same meaning we previously associated with it.
In many instances we see at AgingParents.com, where we consult with families on healthcare, legal, and psychological issues, we witness family conflicts about an aging parent’s decline. Some are accepting and willing to accept the “long goodbye”. They recognize that their loved one’s body is preparing for the end. Other family members are in complete denial and want to keep pushing food and other things on the dying aging loved one. Some have remarked that our American culture is the only one in the world that seems to think death is optional. We see a lot of family members for whom that is true.
When the elder is alert and hears the urging to eat or drink something, they will sometimes comply just appease the adult child or caregiver, even if they don’t feel at all like eating or drinking anything. But it is not fair to them, when they are nearing the end of life, to focus on anything other than their comfort. Food probably is not comfort at all, even if the family wants it to be. And forcing, urging or pressuring a declining elder to eat more does no good. If they’re dying, eating is not going to prolong their lives.
- If your loved one is starting to refuse food or eat only very little, consider the aging parent’s circumstances. Are they in a state of terminal illness? Don’t be afraid to ask the treating M.D. Unfortunately, some M.D.s are also not particularly comfortable with death and dying so you will not always get a straight answer. You can ask the treating physician whether they think it is time for hospice. Get to the question: should you push food on your loved one?
- If you have thought about hospice care or comfort care, reach out to a local hospice and get a consultation. That is where you will get a focus on peace and comfort for your loved one, rather than futile treatment, tests, and more medications. Hospice provides what is called “palliative care”, meaning they are not trying to cure or fix anyone. Rather, they want the person to feel supported, and free of pain insofar as possible. Medicare pays for hospice care but it must be ordered by a physician. The determination is that the M.D. believes the patient has six months or less to live. That’s a guess, but it is permissible to Medicare.
There is no question that the idea of a person’s imminent death is uncomfortable for most families. Part of this is our own culture. Part of it is family member’s terror of letting a loved one go, or anger that this is real. Pushing food on a person whose life is waning is an expression of that fear or anger. At AgingParents.com, we promote and conduct family meetings to help educate all involved and if they’re willing, to reach acceptance of what is going on. If your family is in conflict about these end-of-life issues, we encourage you to get help in the community or online with resolving it in family meetings. Look for “elder mediation” or “elder care mediation” in your search. A neutral licensed professional can help families reach acceptance.