To avoid making food a source of stress and conflict between you and a loved one undergoing cancer treatment, think of your role as similar to that of a hostess at a party: You want to offer a delicious, nutritious meal, but after that it's up to him to decide when and what to eat. Do be proactive and work with his doctors to combat and reduce the nausea as much as possible . But as far as eating goes, all you can really do is offer plenty of choices and make the experience as pleasant and as stress-free as possible. Some strategies that help:
Keep track of everything related to a cancer patient's appetite
His experience with nausea and vomiting may change constantly, making it tough to figure out what to serve on any given day, says Redwing Keyssar, palliative care coordinator for Seniors-at-Home, a program of Jewish Family and Children's Services in the San Francisco Bay Area.
"You need to be observant and notice everything that seems to contribute to the nausea and keep track of what you're seeing," Keyssar says. She recommends keeping a log and writing down "all the strange little details," such as times of day that he was able to eat or not eat, and anything you notice that was going on prior to a bout of nausea. "Write down everything -- 'I tried to give my father this, and he got sick,' or 'at 3 p.m. three days in a row he felt sick.' Don't rely on memory," she says.
After doing this for a few days, you might notice that he has a better appetite in the late morning, so you'll start serving an early lunch. Or you might observe that certain foods seem to trigger a "nausea backlash" a little later, even if he feels fine while eating them.
Keeping careful track of someone's battle with nausea and lack of appetite will also help you work with his doctor to get more help, Keyssar says. "If you become better at assessment and communicating what you're seeing, it will help his doctor think about what to try next."
Focus on calories, not nutrition, for a cancer patient
You want to serve healthy, balanced meals. But what matters most is that he keep his strength up. If all he wants to eat is sweets, this isn't the time to worry about that. In fact, weight loss is the enemy of cancer patients, so high-calorie foods are preferable to low -calories ones if he's struggling to keep weight on.
There are also some easy ways to boost the calorie content of the foods he's already eating. Substitute whole milk or cream in hot chocolate, oatmeal, and other cereals and any recipe calling for milk. You can add whole or whipping cream to desserts, pancakes, and waffles and even to mashed potatoes and pureed vegetable soups. Use butter in sauces on vegetables and fish, or make a rich gravy for meats. And top cakes, pies, and other desserts with whipped cream, ice cream, or cream cheese frosting whenever possible.
If there's a dish that spurs his appetite, don't worry about whether it's what he "should" be eating. This isn't the time to be overly concerned about fat, cholesterol, or other nutritional issues. Think about easy-to-eat snack foods that he has liked in the past, even during his childhood. Muffins, pudding, ice cream, cheese and crackers, and peanut butter are often popular with cancer patients. One caveat, though: During periods of extreme nausea and vomiting, when nothing seems to tempt him, you might want to avoid serving his favorites. Otherwise something he really likes may become associated in his mind with nausea, removing another key dish from the list.
Help control nausea by encouraging liquids and small, frequent meals
Many cancer patients find it easier to sip drinks all day than to eat solid foods. Also, if he's having problems with his mouth or throat, such as dry mouth or mouth sores, liquids are much easier to get down.
Luckily, a primarily liquid diet is a perfectly healthy approach to eating. Try serving hot -- or lukewarm -- chocolate, cider, milk, milkshakes, Gatorade, and juice. These are great ways to help him consume calories -- often nutritious ones -- without feeling sick. Serve broth-type soups in a mug for sipping. Mix fruit and yogurt or fruit and ice cream into smoothies and boost the protein content with a spoonful of protein powder.
Diet or nutritional supplement drinks such as Ensure, Boost, or Carnation Instant Breakfast also provide calories, protein, an
d nutrients. And because many of them come in cans and don't need to be refrigerated, you can take them along when you're at doctor's appointments or running errands with your family member and offer them between meals. And if his doctor says it's okay, try serving a small glass of beer or wine with meals; it can help stimulate appetite.
Another effective way to control nausea is to eat many small meals throughout the day rather than a few big ones. However, when he doesn't feel like eating, it's easy for him to forget to eat for hours on end. Talk to him about setting up a system of meal reminders: does he want you to call him throughout the day to check up? Or perhaps you could set up a schedule of mealtimes, such as every two hours during the day.
Professional caregivers recommend setting a timer for 60 minutes and encouraging the person you're caring for to eat at least a few bites every time it goes off. But this can also be an annoyance, so it's something you'll want to try on an experimental basis. If it doesn't work for him, forget about it.