Appetite and Weight Loss

Families and friends often worry when they notice a loved one eating less, fearing it will hasten death. You can reassure them by:

• Ensuring the older person has been assessed to determine there is not a treatable reason for weight loss or change in appetite such as constipation or unsuitable food options
• Letting the care team know if someone develops swallowing difficulties, nausea, vomiting, diarrhoea, constipation, or stops eating and drinking completely.

Under these circumstances, the person could be supported in the following ways:

• A dietitian can recommend suitable foods and drinks to maximise intake where appropriate
• A speech pathologist might conduct a swallow assessment and recommend a suitable diet texture e.g. softer and easier/less tiring to chew

However, once appetite declines because of health deterioration towards end of life, it is important that we reassure by:

• Explaining that eating less is part of a life-limiting illness or age-related deterioration generally and not something to force
• Encouraging eating for pleasure rather than nutrition—small portions of enjoyable, easy-to-eat foods can help
• Suggesting family and carers shift their focus from food to connection—mealtimes can still be a social experience.

Support the person’s needs by:

• Removing regular weighing or a focus on nutrition and weight outcomes
• Arranging a team meeting with the older person and their family to discuss end-of-life choices for eating and drinking
• Encouraging carers to help with keeping the person’s mouth moist and comfortable once they no longer want fluids.