living your best to the end

Hunger and thirst: our needs diminish as life ends

Planning for end of life for those with specific medial conditions: Not able to eat or drink “I have conversations every day about food and supplements for frail elderly and even those with early stage dementia.” Dr. Michael Gordon Geriatrician, ethicist, educator, speaker, author and Medical Program Director Palliative Care, Baycrest Centre for Geriatric Care There’s so much more meaning to food and eating than merely getting nourishment. Food represents caring, nurturing, contact, love. The decision not to feed via tube (PEG – via tube inserted into the abdomen or NG inserted up the nose ) or hydrate via intra-venvenous (IV) would seem, as Dr Gordon says: “abandonment of a basic need of a loved one” or, I’ve often heard described as ‘starving him/her to death.” As I’ve learned, this is a gross mis-representation of the reality of our needs as life comes to an end. Dr Gordon explains: “What most people don’t realize is that eating needs at the end of life are much different any other time. For example, in religions where fasting is part of the culture – such as Jews or Muslims – by the end of the day they’re tired, rather than hungry. However, if you’re well, at the end of the fasting day, the first food you smell or put into your mouth triggers the brain and body and you’re hungry. Not so in the later stages of life.” Feeding at the end of life  – whether by mouth or tube – comes with complications: agitation nausea, coughing  and aspirations – inhaling food into the lungs – which often results in pneumonia which...