Nutritional Care for Hospice Patients
A patient who has decided to obtain hospice services is reaching the end stages of her life and is therefore in a very sensitive state of mind when in comes to nutrition. Due to the illness, the patient may not feel like eating much and in many cases may not be able to swallow normal solid foods. Often the individual will slowly stop eating as the disease begins to accelerate and shut her body down, so it is entirely up to the hospice care providers to encourage the family to allow this process to occur. Since people in hospice have a terminal prognosis, hospice's role is to provide comfort at end the end of the patient's journey. If eating food causes discomfort, hospice will quite often allow the patient to eat as little as he or she desires without suggesting the addition of a feeding tube or other means of prolonging life.
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Appetite
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It is perfectly normal for a hospice patient to lose his appetite. In fact, the closer the patient gets to dying, the less he will want to eat. Part of the hospice worker's job is to assess the patient's appetite level to help make him more comfortable with the process. If the person's appetite has significantly decreased, the hospice caregiver will suggest keeping the individual hydrated. If the patient also refuses liquids, it is only necessary to wet his lips to maintain comfort. Forcing the patient to eat when he has no appetite serves no purpose and will in all likelihood cause discomfort.
Accommodate
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Accommodate the patient her feel more comfortable with the fact that she is eating less, even if it is due to the illness rather than a choice. Providing drinks and shakes that add protein and vitamins to the patient's body is an excellent method of supplying her with nutrition without forcing her to eat solid foods. Offering less food less often also makes hospice patients feel at ease since it places less pressure on them to consume foods that are difficult for them to eat.
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Metabolism
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As the terminal illness progresses, a person's metabolism is seriously altered. While a healthy individual has a metabolism that turns food into energy used to live, a person reaching the end of life has no use for this function. The hospice workers look for signs of metabolism changes and alter the patient's nutritional intake accordingly. As the metabolism slows and then comes to a halt, food will serve no purpose within the body even if the patient is able to consume it.
Family
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It is vital that hospice explain the patient's nutritional needs to the family. Most family members will not be able to accept that their loved one no longer wants to eat. It will seem as though the patient is starving to death and the family will become emotional and insistent that the patient eat. Hospice plays a crucial role in explaining the natural course to the family.
Feeding Tube
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Hospice will usually not suggest using a feeding tube for a person that has already reached the end stages of the illness. Prolonging the life of someone who is about to pass on only makes things more difficult for everyone involved. If the patient has only just received the news of illness or cannot consume solids but has a strong will to eat, hospice will offer a feeding tube as a method of administering nutrients.
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