People with cancer nearing the very end of their life can lose interest in eating and drinking. Although this is a part of the dying process, it can be difficult for family and friends to cope with.
Loss of appetite and eating less
People in the advanced stages of illness often lose their appetite, especially in the last few weeks of life. This might be due to other symptoms such as pain, sickness or breathlessness. You might also feel too tired or fed up to eat. Or it could be that you simply no longer need to eat so often.
Gradually, as the body begins to shut down, it can’t digest food. So even small amounts of food might make you feel uncomfortably full or sick. Or you might find that eating gives you stomach pain or diarrhoea. Don’t feel you should force yourself to eat if you are at this stage. Just eat when and if you feel like it.
Other people's reactions
Your friends and family might have trouble understanding that you don't want to eat. They could get very upset and try hard to make you eat. They might feel that if you eat, things will be OK.
It can be difficult if the people around you keep offering food you don't want. And it might cause bad feelings between you when you both need support and understanding.
Coping with other people's reactions
Explain to the people around you that:
- you don't feel hungry
- eating makes you feel uncomfortable
- you feel better if you don't eat
It’s important that your family and friends recognise that the best thing they can do is just be there for you. If you feel like eating, that's great. But if you don't, they shouldn’t try to get you to eat. As one doctor explains, “Lack of appetite isn't painful, but eating can be if your body can’t cope with food”. Knowing this might help your friends and family accept that you don’t need to eat.
Sometimes relatives might want you to have liquid food through a tube into your stomach or veins. But people who are in the final months or weeks of life don’t necessarily live longer or get stronger if they are fed in this way.
You stop eating because of the way the cancer is affecting your body. People who have tube feeding need close monitoring with blood tests. So doing blood tests and giving feeds could cause distress and discomfort. The main aim of your healthcare team is to keep you comfortable.
Keeping up your fluid intake might help you feel better if you can manage it. There are also different types of liquid meals you might like to try. But if these make you feel uncomfortable, don't force yourself. You can drink water and tea instead, or whatever you fancy.
Having fluid to relieve dehydration
People with cancer nearing the very end of their life can lose interest in drinking as well as eating. Although a person may be dehydrated, they don't necessarily feel thirsty.
Research shows that many people are actually more comfortable when their body doesn’t have to deal with too much fluid.
Sucking on ice chips or having sips of cold water can help to relieve symptoms if you are thirsty or have a dry mouth. But if you can’t suck or drink, your carers can regularly clean and moisten your mouth and lips with swabs and lip balm.
If you can't drink and you do feel thirsty and uncomfortable, your doctor might suggest giving you fluid through a drip into your vein. Or you can have fluid through a small tube just under the skin surface (subcutaneously). This is called parenteral hydration.
You have this fluid to relieve the symptoms of dehydration. It is not to cure your illness or make you live longer. Your doctors will explain what having the fluids involves and ask you and your relatives to agree to it. Having injections and drips can be uncomfortable. Your doctor will discuss this with you if they think that giving you fluids will cause more distress than relief.
When someone is close to dying, they are often not able or willing to drink at all. At this point, they are only likely to live for a few days at most.
Marie Curie is a charity that has more information on all aspects of dying, death and bereavement. It includes information on eating and drinking problems at the end of life.