Mom has inconsistent eating behaviors, what is causing this behavior?

1 answer | Last updated: Sep 14, 2017
A fellow caregiver asked...

My step mom is in a nursing home and her hospices Doctor told me that she has six months to live. Sometimes she'll eat her food at every meal, other times she'll go days without eating. Can you explain to me what's causing this behavior? What is the medical term for this behavior?

Expert Answers

Audrey Wuerl, RN, BSN, PHN, is education coordinator for Hospice of San Joaquin in California. She is also a geriatric trainer for the End-of-Life Nursing Education Consortium (ELNEC), which promotes education in geriatric nursing and end-of-life care.

It's hard to know what is going on with your step-mom because you did not state her diagnosis. But, one thing is clear"”families are distressed when their loved ones no longer want to eat.

Bodily demands change as people approach the end of life. The desire to eat diminishes, and food does not taste the way it used it. It becomes harder and harder to metabolize food. Further, the body is starting to prepare for death. This is all natural and expected, and if allowed to proceed, the patient is generally more comfortable as death approaches. You may have noticed your step-mom having some difficulty swallowing. If you did, please report it to the staff so they can thicken her meals and monitor her for safety with swallowing.

She may just be too tired now to eat. If you observe her eating her meals, is it in your presence? Is she eating just to please you? When you say she does not eat "for days" I'm wondering if she is in pain. Talk with the nursing home staff"”let them know your concerns"”and ask them what others changes they have noticed. Find out if she is receiving medications that have been ordered for her. It is difficult at times to know if the patient is having pain, especially if they cannot verbalize that.

I like to tell families that patients at the end of life are much like tall buildings with many floors: while initially all lit up, we start to see the lights going out and the floors going dark. Is there a medical term for not wanting to eat? Not really. But, in the case of most patients, when they naturally give up food or fluids, any swelling decreases, there is less nausea, and less shortness of breath. Our philosophy at my hospice is that when the desire to eat stops, allowing your loved one to refuse food is one of the hardest, but kindest things you can do.