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 The body reaches a point where it is asleep all the time, non responsive (completely withdrawn from surroundings) and not eating or drinking.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
Yes I have a question. My 93 year old mother was diagnosed with pancreatic cancer 7 months ago and has been on hospice for 6 months. About two weeks ago she was not eating or talking mostly sleeping. We thought she was leaving. Then she started feeling better and started eating again and talking a lot. It has been about 2 weeks for this Improvement. Everyone is shocked even the hospice people. Is this a common occurrence?
Hi Carolann, I don’t have a enough medical history to be able to put a time frame on your father’s progress. You might find my booklet Gone From My Sight helpful. You will be able to see signs that occur weeks before death, then hours and minutes. It can give you some guidance. You might talk with his doctor about a hospice referral so you both have support.
My blessings are with you, your father, and your family. Barbara
Hi BARBARA, this is the first article I’ve seen that actually explains the process of dying from old age. My father is 96, almost 97 and for a number of months now has gradually decreased food and liquid intake along with social withdrawal and increased sleeping. My family and I have been worried, thinking he was dying but not having confirmation from health professionals. I feel so relieved now, having read your article. I won’t nag him anymore to eat or drink, I believe he has the right to do whatever it is that makes him happy.
One question – I find it so difficult trying to predict how long this process will take and have had my life on hold now for several months. Can you give me any idea re timelines please? My father has always been very healthy, has some renal failure, some high BP and some atrial fibrillation.
Hi Cathy, based on what you have described of your mother’s behavior it does appear she is in “labor’ to leave this world. Labor is usually weeks but there are so many dynamics to dying that no one can be specific—it is always a guess. What can you do? Sit with her, hold her hand, talk with her even though she doesn’t respond. Tell her your comings and goings. Tell her you understand she is leaving you and she can go whenever she is ready. Talk about the good times in your life and talk about the challenging times also. She will hear you even though she may not be responding. If you have not read my booklets Gone From My Sight and The Eleventh Hour they will be very helpful to you right now. You might want to get the ebook End of Life Guideline Series so you can have the information now rather than wait for the US mail. If she is still here next month you can reevaluate whether you need to return to work. If you do, tell her of your struggle, how hard it is to not be with her during this time but you need to pay your bills. Know that some part of her will understand. You can always stop in after work and sit with her for awhile. If she is your best friend then she knows how much you love her, want to be with her. You’re doing a good job of loving and caring for her. I’ll bet she knows this.
My blessings are with you and your mom. Barbara
Hello, and thank you for this blog. My mom is 81, she has COPD and is in stage 4 of renal failure. She took a fall last September, and I remember thinking, this is no big deal, I called the paramedics. She was unable to walk. She didn’t want to go to the hospital, but I insisted. I did think it would be simply an overnight thing. But, it turned out she was in the hospital (her muscle and heart enzymes were way out of wack, but she did not have a heart attack).
She was too weak to go back home, so she went into a rehabilitation center. She was there for almost four weeks, and not getting stronger.
Although I said I would never put her in a nursing home, I had to. I felt she needed care 24/7, which has turned out to be very true. She has fallen, she shows no interest in anything, even TV, which is very different from where she had been. She just sleeps, and if she is not sleeping, she is just not there. She has COPD, so that, in and of itself, makes it hard for her to talk. She has not eaten but a few bites of pudding, in over three weeks. She doesn’t drink water, but she loves McD’s coke, She knows the difference, between that and regular coke, lol. I brought her her favorite milkshake the other day, she took one bite, and didn’t want the rest.
I brought in Hospice last week. To be honest, I am not very impressed. They did an evaluation, the nurse visited once, and they brought her a bed that will not allow her to fall out.
When I was there last night, she appeared to be awake, with her eyes wide open, but she wasn’t blinking…or at least very little. She would not take water, and only a few sips of coke. I have taken a leave of absence from work to be with her. I try to talk to her, tomorrow I am bringing in her favorite music.
I am crying right now, because I feel at a loss as to what to do. Taking the leave of absence is a wonderful gift, but I am struggling financially; I am struggling between my desire to be with her and also go to work. I really think she doesn’t have much longer to live. I want to be there for her.
After reading so many posts, I feel at odds with myself. I don’t want to be selfish, she is my best friend. Not knowing if she is for certain passing in the next month, or if it will be months, has my stomach in a knot. I feel she is ready to go, I don’t want her to go, yet, she has no quality of life, so I want to let her know it is ok to go. Oh my lands, this is an internal struggle for me. And I feel selfish.
Any suggestions would be greatly helpful. Thank you so much for this wonderful forum!
All the best,
Cathy
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