Challenges of Eating at the End of Life: a narrative review

Abstract

Introduction: Food is a basic human need throughout the course of a human being’s life, with a multifactorial character. It is associated with comfort, affection, compassion and, in its absence, with the progression of the disease and the proximity of death. Managing the loss of the ability to eat is a huge challenge for the patient, family, carers and care team. Aim: To identify the challenges, perceptions, strategies and nursing interventions in managing end-of-life feeding. Methodology: A qualitative study was carried out through a narrative review using the Scielo, Pubmed, Web of Science, Medline and B-on databases. The following inclusion criteria were defined: complete scientific journal articles published in Portuguese, English and Spanish between 2018 and 2024. Of the articles consulted, six were selected. Results and Discussion: Throughout human life, eating is associated with family experiences of sharing, celebration, comfort, affection, compassion and care. As the disease progresses, pathophysiological changes arise that affect the patient’s and family’s life activities, particularly eating. At this time, eating can be perceived by the family as anguish and as bringing death closer. The values and beliefs about feeding are not fully known and perceived by nurses, with difficulty in knowing the ideal time to stop, knowing the impact and meaning attributed by the patient and family, becoming an attitude of therapeutic obstinacy. Conclusion: Eating at the end of life is a challenge for nurses specializing in medical-surgical nursing for people in a palliative situation, from diagnosis to the implementation of nursing interventions, in order to promote comfort and dignity for the patient and family/caregiver.