Dinner with the Dying

Dinner with the Dying

In the past few months, I’ve had occasion to share food with those preparing to enter eternity relatively sooner than I am. Yesterday, I was visiting a terminally ill aunt when dinner arrived. The nurse put down the tray, lifted the lid, and murmured (somewhat impoliticly I thought), “Yuck.” I actually whacked her on the arm and said, “Hey! That’s not going to help. Have you ever tasted this stuff?” She hadn’t ever eaten the food at her hospital (!), so after my aunt had a spoon of everything and announced, “I don’t want any of this,” the nurse and I dug in.

There’s nothing novel about blasting hospital food, but this was, for me, a new nadir of what’s considered edible. Here’s some of what we had.

• Deconstructed ravioli. The pasta part of the ravioli had been pureed and ice-cream scooped into a bland mound; even less appetizing was the meat sauce and filling, which also had been ground up and plopped on the plate. The two half-globes – one beige and the other orange-red – looked like no food I’ve ever had, and the complete absence of seasoning rendered both surprisingly similar in taste. It was eerie.

• Mashed potatoes. The best thing on the plate. No salt, no butter, though apparently made from real spuds and looking like regular food, so points for that.

• Zucchini puree. A lime green mass looking a little like jell-o, it was squash put through a blender or food processor, but with so much corn starch added to thicken it that it was impossible to eat without an immediate sip of water to lubricate the tasteless pulp on the way down. “Vile,” I said. “Vile,” the nurse agreed.

I can’t say I expected to be wowed, but the flavors were so flat, the textures generally so unnatural and unappealing, that it’s not surprising my aunt is not eating. She’s “failing to thrive,” but thriving is hard when food, one of the main reasons for living, has been largely removed from the menu. I’ve got no fixes here; I understand the medical necessity of a limited hospital diet; but it’s not surprising those who eat it may seem to lose the will to live.

My future Grandfather-in-law is in the hospital currently, having just had a bunch of important digestive type things removed due to some pesky tumors last week (not cancer, thankfully, but they had to come out none the less). It is so hard visiting and seeing what he is just now (a week post-op) getting to "eat". At least he has moved passed ice chips. But when apple juice is the only thing he gets to look forward to consuming...gosh, that is hard. I learned to cook primarily to feed and care for people around me, and I've always done a lot of home-cooking caretaking for friends and relatives; it is a big part of how I show that I care about them. Losing the ability to do that for someone, and seeing what their "food" is limited to is crushing.

I'm sorry about your aunt.

Even with real, home-cooked, flavorful food, it can be a chore.

When my father was dying, I visited him in California and cooked a huge feast one night. He was unrestricted in his diet and was encouraged to eat as much as he could keep down. Fortunately he was in home hospice and there was a full kitchen.

I was optimistic and I think he had some extra energy because I was in town, so he encouraged me to cook. I made filet mignon with a mushroom-bacon pan sauce, roasted potatoes, asparagus with hollandaise, and picked up a fresh fruit tart from a local bakery for dessert. He loved looking at the food and tried to eat, but just couldn't.

Sorry to hear about your aunt, David. It stinks to try to keep your strength up with bad food, but even when it's good food, it can be just as hard.

Best,
Michael

eatchicago wrote:He loved looking at the food and tried to eat, but just couldn't.

Just looking at good food, like looking at flowers, might make one feel good...or maybe not, if it simply tantalizes and is impossible to taste.

Hi,

When my Grandfather was getting older, he began refusing food or at least eating too little. He developed a yeast infection in his esophagus from eating too little. It began a vicious cycle because he ate too little, he had the infection. When he ate, the infection caused him to regurgitate. I realize that is not a pretty thought first thing in the morning, though it illustrates the delicate balance it takes to thrive.

My Grandmother didn't know who she was, what day it was and was largely uncommunicative the last few years of her life. Her nursing home was less than 15 minutes from our house, which made random visits very convenient. Since there was only a one-way conversation, I would bring food. It could be a hamburger picked up along the way, some dessert from our dinner or even a portion of our dinner. Whatever we brought was wolfed down eagerly. I visited for about as long as she was eating, then tidied her up and left.

Food wiped clean of fats, salts and spices is very unpleasantly utilitarian. It may meet some nutritional norms, though if it is not attractive to the tastebuds to eat, then what's the point.

When my Grandfather was dying. They were carefully metering the morphine, which clearly wasn't enough to overcome the pain. My thought was the guy is dying, the chance of addiction is zero, why not let him leave on a painless cloud? I feel the same way about food, let them eat what makes them happy. Of course, the dietician in the hospital or nursing home has not just one person to please and some do have a chance to live on, though who responds well to tasteless food?

My best wishes to your Aunt.

Regards,

I did some candystriping as a teenager, feeding was one of our primary responsibilities, and it was a task that is indelibly printed on my mind; spoon feeding blobs of the incomprehensible into waiting mouths. I understand the need for purees, but there are so many of those that are so much more palatable than what's cooked up in a nursing home. It's a shame.

It's a good thing, though, to try it yourself and see what it's like; these things are changing (slowly) for that reason alone. Kudos to you, David - and my sympathies and good wishes for your Aunt

I spent a bit of time in the hospital a number of years ago. Although there was a short period of time where I truly couldn't eat anything but liquids, I always appreciated it when someone brought in food from the outside. Whether it was pasta from Tuscany or just a milk shake from a hot dog stand, the food was universally better than what the hospital was putting on my tray. The effort of friends and family to bring in outside food was greatly appreciated and always made me feel better.

P.S. I ended up not dying and I think the outside food contributed greatly to that outcome.

First, I'm sorry to hear of your Aunt's illness.

We went through something similar at Rush back when I was a kid. In the 1980's my Aunt had been diagnosed with uterine cancer and was slowly slipping away after many rounds of failed chemo. One of the things that was the hardest was on the good days the food was so bad she woudln't eat. We snuck a lot of food in, we figured, that it didn't matter at that point anyway and she seemed the most happy with milk shakes and sliders.

There's a product out there to use as a thickener for foods called Thickit, we used it after one of my uncles had surgery on his esophagus. It allows you to control the thickness you are trying to get and it also lets you add this to your home cooked items. We were using this because my uncle was at risk for aspiration during his recovery. I'm not sure if that's something your Aunt is at risk for. One of the things we did was make home made applesauce and add this to it. I think it worked well on home made soups.

I'm not sure if you're allowed to bring food in but if you were and you were so inclined to make a home made soup ect for her my Uncle preferred this to the cornstarch we had tried to use previously.

Honestly, the food at my hotel stay last month was better than most of the restaurant food that I have been eating in the past month.

Your aunt is on some sort of pureed diet. And there is not a whole lot that you can do to make it a whole lot more attractive. We used to use pastry bags to try to "dress it up" but that could make it look even worse. Personally, I would almost wish that they would use a tube rather than giving pureed foods BUT that is not my call.

Pureed zucchini is just that. I really doubt that they are adding a lot of corn starch. Pureed zucchini really does look THAT bad.

As for the terminally ill, we used to give them pretty much anything that they wanted to eat as long as they thought they could handle it.

jlawrence01 wrote:Pureed zucchini is just that. I really doubt that they are adding a lot of corn starch. Pureed zucchini really does look THAT bad.

I'm fairly positive there was some starchy component in there (perhaps just the thickener mentioned above). It was firm and gelatinous and very challenging to swallow.

Hi,

In my other life in Moscow, there were a few occasions when people I knew were in the hospital. Private or semi-private rooms didn't exist unless the patient needed to be quarantined or poltically very well connnected.

A hospital ward was a large room with multiple beds and a common refrigerator. Visiting family members were expected to bring food and often medications, too. Often the doctor prescribed a certain diet to the family, which almost always sent them on a chase around town to find some specific ingredient. Family and close friends would take turns sitting with the patient to make sure they got the best attention. The unluckiest patient was one away from a supportive family, because they had to eat the hospital food and no advocate to oversee their care.

David, your Aunt is certainly lucky to have you overseeing her affairs.

Regards,

David Hammond wrote:I'm fairly positive there was some starchy component in there (perhaps just the thickener mentioned above). It was firm and gelatinous and very challenging to swallow.

That's what brought my previous pasta reference to mind. Would she be able to eat some very overcooked pasta? If so, she may find the satisfying taste of carbs to be soothing. Comfort food and all.

People from around the world post pix of hospital food; note to self: if you have to be hospitalized, try to do so in Western Australia or Japan.

When my father was dying of cancer and wasting away, I would make or pick up things on the way to see him that I thought would be easy for him to eat and would also taste good. I would bring milk shakes (that he could drink when they warmed up a bit) and butterscotch candies that he liked to suck on. One day I picked up some tapioca pudding. When I got there, I said " hey Dad, I brought you some tapioca pudding, I thought it would be good!" He replied, "Sure it would be good, if I LIKED tapioca pudding" Sense of humor to the end...

Currently my Mom is in hospice care dying of lung cancer. Strangely enough, the food is decent so she eats virtually everything (except the zucchini, she hates it with a passion). When she was still at home I did quite a bit of cooking homey-comfort food for her, which I really enjoyed.

Most hospitals will either let you provide or will provide special items to terminal patients, especially if it will encourage the patient to eat. Contact the hospital's registered dietitian and you can generally arrange it.

It reminds me of an encounter that one of my dietitians had when speaking to a 92 year old patient and his young oncologist. When asked what he would like, he said that he wanted some fine sipping whiskey brought to him. The oncologist objected saying that the interaction with the drugs might kill him. The patient responded, "Like the cancer isn't killing me?"

He was granted the wish.

jlawrence01 wrote:Most hospitals will either let you provide or will provide special items to terminal patients, especially if it will encourage the patient to eat. Contact the hospital's registered dietitian and you can generally arrange it.

It reminds me of an encounter that one of my dietitians had when speaking to a 92 year old patient and his young oncologist. When asked what he would like, he said that he wanted some fine sipping whiskey brought to him. The oncologist objected saying that the interaction with the drugs might kill him. The patient responded, "Like the cancer isn't killing me?"

He was granted the wish.

The problem is getting food to her while it's still hot and edible. There are no kitchen facilities where she is because they bring her meals to her from the main hospital. I live in Round Lake beach and she's in Skokie, so that's a bit of a problem.

My uncle passed away last week, mainly from old age. He was a man who loved his food. In fact, he changed nursing care facilities several times based on the quality of food being served. Right up to the end, even though he was aspirating some of his food, he demanded (and got) his food. I have to say that while I did not relate to my uncle and his life philosophies, I could relate to how he felt about food! Here’s to you Uncle Clarence…I hope they have a good kitchen wherever you are.

MikeW665 wrote: The problem is getting food to her while it's still hot and edible. There are no kitchen facilities where she is because they bring her meals to her from the main hospital. I live in Round Lake beach and she's in Skokie, so that's a bit of a problem.

There are large stainless vacuum-style thermoses that can be used to transport food if you want to bring her a hot home-cooked meal, their capacity to retain heat is amazing. (actually, any kind of a cooler will help keep food hot as well as cold, one of Alton Brown's DIY widgets is for a "hot box" using a cooler and wrapped, heated bricks.)

Hi,

I learned from Bruce Cook to fill a cooler with hot water (I used boiled from the stove), then let it sit a few minutes. Dump the water, dry the interior, load with food and fill with crumpled newspaper to fill the voids.

I once smoked hot links for a Katrina related dinner. I heated my cooler as described above. I filled ziploc bags with the hot links, then spent over two hours on the expressway crawling to Brookfield, IL. They arrived as hot as they left my smoker.

The heat retention is so impressively good, you have to wait for your food to cool to eat it.

Regards,

MikeW665 wrote:The problem is getting food to her while it's still hot and edible. There are no kitchen facilities where she is because they bring her meals to her from the main hospital. I live in Round Lake beach and she's in Skokie, so that's a bit of a problem.

Satellite kitchens are the bane of acceptable meals in a hospital.

I had the misforune of setting on up in a large hospital in Virginia. Food was plated refrigerated, delivered to the floors and magically rethermalized just like an airline meal ... and nearly always to the detriment of the food.

There are some products produced by Thermos (don't use the stuff produced by Trudeau in Canada) that can keep food hot for hours. Coffee made at 7 am is still well above 130F at 3 pm in my thermos.

Using a cooler as a hot box is a fantastic idea, I better get cooking.