Speech and Language Therapy - Eating and drinking in the last days of life

This leaflet may be helpful for family/friends/carers who are unfamiliar with eating and drinking in the last days of life.

Eating and Drinking at the end of life

When someone transitions to end of life care, eating and drinking should be for comfort and pleasure. If your family member or friend is requesting oral intake and are awake enough, they should be offered food and drink.

There is a risk that your family member will not meet their full nutritional needs, they might cough and there could be a risk of food and drink going down the wrong way, into their airway.  Remember – eating and drinking at this time is for pleasure and quality of life.

What might change to someone’s eating and drinking when they are approaching the end of their life?

When a person is approaching the end of their life, it’s normal for their appetite to change and reduce. Don’t over-face them – just try small amounts at a time.

There might be changes to smell and taste.

They might also be more tired in the last few days of life.

When a person is approaching the end of their life, try not to worry about how much a person eats and drinks, the focus should be on enjoyment of what they have.

Mouth care

Keep their mouth clean and moist using the mouthcare packs (ask a member of staff) or use the person’s favourite mouth care items e.g. lip balms, moisturisers.

There are tubes of oral moisturising gel available on the ward which can help keep the mouth and lips moist.

If you are using sponges, given by the nursing staff, you can dip these into a flavoured drink, squeeze off the excess liquid and use this to wipe around their mouth. Only use the sponge sticks that are available on the ward.

Top tips

Don’t worry if your family member or friend isn’t awake enough for eating and drinking, or they have no appetite. There can be fluctuations in alertness and appetite at the end of life. However, if they are alert, are sat as upright as possible and are indicating they would like something to eat or drink then this is the right time to be offering food and drink.

Smoother foods like ice cream and yoghurts, might be easier to manage but they should be given what they would like at their discretion.

Staff on the ward will be able to support you with things for your relative/friend to eat and drink. Some hospital sites have dedicated ‘Swan Fridges’ with items such as ice-creams and ice lollies that are available at any time during the day and overnight. Please speak to the nurse if you want items from the fridge or to see if there is another menu to order from and with appropriate options available.

Your family member/relative may find it difficult to feed themself. You can assist by guiding their hand to their mouth, or fully support them, and be present when they are having food and drink.

Small amounts on a teaspoon might be easier to manage rather than over-filled teaspoons or big sips and mouthfuls.

Your relative or friend might be quite tired, so give extra time for chewing and swallowing. Ensure their mouth is clear before offering further teaspoons/sips. They might need to do an extra swallow to clear all of the food and drink.
 
If your relative/friend is coughing when eating and drinking, encourage them to take a break and try again another time. Remember – eating and drinking at this time is for pleasure and quality of life. If your relative is persistently coughing and appears distressed by eating and drinking, discuss this with their nurse.

Useful contacts

The Palliative Care team are really helpful for providing support. They can be contacted on:

Fairfield - 0161 778 2679

Salford - 0161 206 4609

Oldham - 0161 778 5918

Rochdale - 01706 752360

If the person seems really distressed by oral intake, speak to the patients nurse and they can contact the Speech and Language Therapy team for advice on supporting with eating and drinking at the end of life.