Eating and drinking in Dutch hospice care

Abstract

People with a life-limiting illness, and everyone closely involved, face many struggles throughout the illness. One of those struggles is related to the diminishing appetite for food and drinks. In Dutch hospice care institutions this struggle has also become apparent with their residents. When they see those near and dear urge their loved one to eat more, in the hope that maybe it will help extend the life of their loved one. Unfortunately, this approach of food care does more harm than it helps. This master thesis explores the food care in a Dutch hospice institution, it studies the areas of concern within that scope, and what may cause these concerning circumstances to come about. The analysis reveals how hospice residents may lack a sense of autonomy over their meals, and how the food care can be inconsistent between different care provider. It results into situations where residents receive unsuitable meals that are difficult to eat, or too large to finish, leading to concern and guilt about the unfinished, and sometimes conflicts with relatives, who urge their loved one to eat more. Furthermore, it becomes clear that the food care can lack in social and emotional values, over-prioritizing the nutritional intake. Finally, those near and dear may struggle to let go of food, however interventions from the hospice to stimulate them to let go usually are too abrupt and therefore unnatural. As a response to these concerns a hospice diary for eating and drinking is presented. It is a diary that centralizes everything that has to do with food care. It provokes a registration of the food and drink preferences of hospice residents, to ensure instantly well-adjusted food care that can be provided consistently between different care provider groups. Furthermore, through daily questions on topics related to the emotional and social values of food, those values are (re)introduced to the context, to distract from the prioritized nutritional values. Finally, fill-in pages stimulate the daily assessment for desired meals. Combined with “instructions” for the assessments, the care providers should become more aware of the necessity to make correct and complete assessments of what the resident truly desires for their meal.