Dear Barbara, I'm facing the choice of having my mother be fed or not as she is barely feeding herself. I need facts to share with my sister on allowing her to go without prolonging life through feeding.
As a person enters the dying process, months before death occurs, they will gradually stop eating. Months before death they will stop eating meats, then fruits and vegetables, then soft foods, then liquids and finally in the days before death they will not even take water. This is normal. This is how people die.
How we take care of people who are dying has changed over eons of time. Dying was once viewed as a natural part of living. Now it is the enemy to be avoided at all costs (literally at all costs in many cases). What was once natural is now medicalized. What hasn’t changed is how the physical body dies from disease or old age. When not interfered with by medical procedures a person will gradually stop eating, slowly withdraw into themselves and sleep more and more. The body reaches a point where it is asleep all the time, non responsive (completely withdrawn from surroundings) and not eating or drinking. This is how people have always died. This is the natural way a body (man, woman, child or animal) dies.
It isn’t that the person doesn’t want to eat. They usually try but state they just “can’t” eat. This is because the eating or not eating has nothing to do with the personality choosing to eat or not. It has to do with the body releasing its hold on this physical plane. Food is what holds us here. Food is our anchor to earth.
This is one of the hardest concepts of dying for people to understand. So much of our life is supported by eating, its sociability, the holidays, and expressions of love, but actually eating’s purpose is to sustain the body, to keep it alive. When the dying process begins it is normal for eating to gradually stop.
When a person’s disease can’t be fixed, and death is going to be its result, the goal becomes one of providing comfort. ALWAYS offering food but not forcing is the comfort we give now. Offer favorite foods, offer liquid protein supplements, offer small, high protein snacks. Forget about three meals a day. Three regular meals is too much food and overwhelming.
ALWAYS OFFER SMALL AMOUNTS OF FOOD FREQUENTLY but don’t force or be disappointed when the food is not eaten. The body is doing what it will always do when death approaches, when we don’t interfere with the wonders of our modern technology. The body will reject the food and gradually stop eating.
Remember we are all going to die some day. Death is very much a part of the life experience. How the body dies naturally is by gradually not eating.
Something More about Food and the Dying Process~
I talk extensively about food in the dying process on my dvd, NEW RULES for End of Life Care. Particularly about the affects of forcing food at end of life.
37 comments
Hi Betty, I really don’t have enough medical history of your mom to know if she has entered the dying process (because of her age and/or disease). She does have the signs I look for, decreased eating, increased sleeping and withdrawing, that tells me a person has entered the dying process. That said she could just be severely depressed. You might think of a mild antidepressant and see if that makes a difference. My guess is it probably won’t. You didn’t tell me if dementia is part of your mother’s medical history. If it is then that is also a factor of what is occurring. What would I do if she were my mom? If dementia isn’t a factor, I’d tell her I was worried about her and why and listen to what she tells me. At 82 with her medical history I would offer advice and offer food, but not force. I would suggest she leave the house with you, go someplace but if she refuses that’s okay. Offer, suggest but accept. My blessings are with you and your mom. Barbara
Hi Barbara! My mom, 82 , was diagnozed with stomach cancer 2 years ago, She refused operation and had 6 cycles of chemo with little improvemnt on CT scans but big improvement in her performance. The disease stopped and she is off treatment for 15 months now. 4 months ago she started losing weight again and although CT scans shows very little progression, my mom is feeling worse and worse. I am confused to what extend her symptoms relate to disease itself and to what they might be caused by mental issues as she was always very neurotic and had symtopms that were not related to any real diseases. She eats very little and stopped going out. She spends most days lying down and sleeping, avoids talking to friends. She is not taking good care about her hygene but does not allow me to help her with that or change her bedsheets. Should I fight over these things or leave her alone and allow her to not eat? She is able to swallow solid foods, just doesn`t want to eat.
Hi Lois, about your mom not eating for 6 days and now beginning to eat—has she entered the dying process? I’m with your hospice staff, I don’t know. Alzheimers is such a tricky disease. It just doesn’t play by any rules. My thoughts are she could be experiencing what I call the "calm before the storm”. She appears to be days to hours from death, then perks up for a few days and then resumes actively dying. Another thought is something could have been occurring in her body that balanced itself. Bottom line we will probably never know what happened or why. I know this has been difficult, preparing for and anticipating her death only to be faced with questions as to what is happening.
My blessings are with you all. Barbara
My mom is dying of copd,chf,late alzheimers. She went 6 days no food water, no output, glassy milky eyes rolled back, talking to loved one who past. She started drinking water yesterday, still confused really weak, today she ate 3 bites of roasted potatoes. Which is crazy. I don’t know if it’s a burst or shes getting ready to pass. Hospice says it could be a bust or spiritual change. Is this normal?
Hi April, a few times I have seen a person reach death’s door and turn around and come back for a while. This doesn’t happen very often but what a gift when it does. I don’t know the medical reasons for this to happen. My take is that the person gets close and says “Wait a minute. There is something I need to attend to.” We will probably never find out what that “something” is. Our part is to take the gift of having our loved one with us a bit longer. Blessings to you and your mom. Barbara
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