When appetite fades in a serious illness: what helps

Few things worry families more than watching someone they love stop eating. Feeding is how we care for people. In a serious illness, though, eating less is often part of the illness itself, and pushing food can make someone less comfortable. This note explains what’s happening and what helps.

Why appetite fades

Serious illness changes how the body uses food. Medicines, nausea, pain, constipation, mouth sores and tiredness all lower appetite. Near the end of life, people often lose the desire to eat or drink as the body slows down, and forcing food or fluids can cause discomfort or choking.¹

Some causes can be treated

Earlier in an illness, ask the care team to look for causes that can be treated: nausea, pain, constipation, a sore mouth, depression or a medicine side effect. Treating them can bring appetite back.

Offer, don’t push

Small portions on a small plate. Favorite foods, at the times of day they feel best. Cold foods if smells bother them. Let them decide how much. Sitting together at mealtimes matters even if they eat little.

Mouth care is comfort

When someone is eating and drinking very little, keep the mouth and lips moist: sips of water, ice chips if they want them, a moist swab, lip balm.¹ Ask the nurse to show you how. It’s one of the most comforting things a family can do.

Feeding tubes

Families sometimes ask about a feeding tube. For people with advanced dementia, the American Geriatrics Society advises careful hand feeding instead of a tube, because tubes haven’t been shown to help people live longer, prevent pneumonia or improve comfort, and they bring risks of their own.² For other illnesses, ask the doctor what a tube could and couldn’t do, and what your loved one would have wanted.

When to call the care team

Call if they can’t keep anything down, seem to be in pain when eating or swallowing, are choking or coughing with food, or if not eating is causing you distress. The team can help with symptoms and with the hard conversation about what eating less means.