When a patient approaches end-of-life, there are often a number of daunting things their hospice provider can help them through: walking, breathing, overcoming confusion and simply the idea that they are approaching end of life.
Among these things, there is one that can be often overlooked from the outside in: the loss of taste at end-of-life. Charlotte Wilkinson, a registered nurse case manager with Crossroads Hospice & Palliative Care, notes that it is extremely common in hospice patients and always something that needs to be considered when providing comfort and care.
During this holiday season, Thanksgiving especially, when food and eating becomes central to celebration and tradition among family, dealing with a patient or loved one who refuses or has trouble eating can become particularly worrisome. The first step to coping and addressing these concerns accordingly is understanding why this happens as well as why it is quite normal among hospice patients.
Why a loss of taste?
“It’s in just about everybody,” Charlotte said.“There are several reasons. The main reason is, as we age, and starting at age 50, we start to lose taste buds.”
It’s not just something that happens in dementia patients. It’s in everybody. The loss of taste happens for a number of reasons and there are certain challenges that it presents for patients and caregivers as well as a number of ways to circumvent those challenges.
As Charlotte said, once we reach a certain age, everyone begins to lose the sense of taste, but it’s not the only reason this happens in end-of-life scenarios. In addition to the natural aging process, other causes of the loss of taste at end-of-life include problems with medications, sinus or dental issues, gum disease, mouth dryness, vitamin deficiency or dementia.
What the joy of taste means to a patient during the holidays.
The holidays are a time of gathering and celebration amongst family, friends, and other loved ones. Central to all of this tradition is the food. What’s a Thanksgiving after all without stuffing, mashed potatoes, cornbread, pumpkin pie, and of course a big whopping turkey at the center of the table?
When the aforementioned causes take hold of a family member on hospice, the annual feast may not have its same spirit that it used to. The physical inability to participate in the celebration coupled with concerns for a patient’s well being can often put a damper on the mood.
In terms of well being, an inability to identify flavor can, as one could imagine, present a number of dietary concerns for patients.
“Sometimes their eating habits can change totally,” Charlotte said. “And what I’ve noticed in just about every senior–all they want to eat is sweets. Sweet taste buds are the last to go.”
With everything going on at end-of-life, Charlotte reasserts that the dietary concerns resulting from the loss of taste remain among the most unsettling.
“It is a huge issue and one of the biggest problems that we have with families,” she said.“That’s just the nature of the beast.
“It happens in every hospice patient that I’ve ever had. At the end-of-life, patients may go two to three weeks without eating anything.”
Changing eating habits accordingly this Thanksgiving.
With a loss of taste, turkey can be difficult for patients to chew but she can offer them things like custard that’s made with ingredients like eggs, supplements like Ensure and Boost that are loaded with proteins, an ice cream called Magic Cups containing proteins and vitamins or even just simply adding extra spices to a Thanksgiving dinner to give it a bit of an extra zing, allowing a patient to recognize an item’s taste a bit more easily.
Aside from what the patients are literally eating, Charlotte suggests making eating a social event. Given patients should not eat alone due to concerns with swallowing trouble, making their meal something special can have quite the impact.
On a holiday such as Thanksgiving, making eating a social should be no trouble given the nature of the holiday itself. However, it is important that this practice spills into a patient’s life outside the holiday for purposes of continued safety and encouragement.
All of this noted, Charlotte reminds us that, because this is an end-of-life event, it’s not always going to be successful.
“You can’t force people to eat,” she said. “Sometimes there’s not a lot that you can do about it.”
But if caregivers and healthcare professionals can help a hospice patient enjoy a meal just a little bit more than before, that’s a win for comfort and care.
“At the very end, if all else fails,” Charlotte said, “we give in without worrying and let them eat what they enjoy. And I’m talking about the very end-of-life. The last few weeks.”
Good hospice care is, after all, in the best interest of the patient and self-determination should be central. In these cases, it can be Ok for your loved one to stop eating entirely on hospice.
To learn about end-of-life symptoms and how hospice can manage them, learn more on the Crossroads website today.
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