Eating and drinking towards the end of life: Information for carers

• People will gradually eat and drink less, sometimes only a few bites or sips
• Interest in food may come and go unpredictably 
• People may become fully dependent on their carer for feeding as their condition changes
• Coughing or gagging are normal as muscles gets weaker and coordination slows down
• Eating and drinking usually stop gradually as someone becomes less conscious

• Let the person choose if and when they want to eat or drink  
• Offer small amounts of soft food, especially the person’s favourite flavours
• It is important not to force food or drink onto someone who no longer wants it as this can cause them discomfort
• Forget scheduled mealtimes—offer food and drink when wanted
• Continue to offer a variety of soft foods and sips of water with a teaspoon or straw for as long as the person is conscious 
• Remember to sit them up when offering food and fluids to avoid choking
• Prepare small, easy-to-swallow portions; liquidising foods can help
• Use ice chips or a small spray bottle to mist the mouth to keep their mouth moist without giving too much liquid
• Create a calm, comfortable environment during mealtimes
• Be ready with practical items like tissues or a sick bowl if needed
• Frequent mouth care can prevent the person feeling thirsty, and will keep them comfortable when they no longer response to offers

NHS Herts Valleys have produced a helpful leaflet (see downloads) with suggested food and drinks.

If appetite is very poor and calories definitely need increasing food can be fortified e.g. with powdered skimmed milk added to hot chocolate or coffee, +/- a spoon of cream or ice cream.