My grandpa Virgil died a few years back. He had 9 lives for sure but one time was more due to imposed dietary restrictions. This guy was hardcore. He survived a ruptured abdominal aneurysm that should have killed him. He had survived a dense stroke many years ago that affected his speech and the use of the right side of his body. That slowed him down but he found creative things to do to still be productive. He was an illiterate genius with a third grade education who was tough as nails and could fix anything. He finally got diagnosed with lung cancer near the end and had broken his hip. This starts the part of the story I want to share.
He was found on the floor at the front door when he broke his hip waiting on someone to check on him. Plug for lifeline here for anyone left alone that is at risk for breaking hips even if someone checks on them regularly. The typical story I have been trained is that once a feeble grandparent breaks a hip, that often signals the end. The same seemed true for him.
While in the hospital, he was evaluated by everyone and given the typical recommendations of "thickened" feeds which he HATED and refused! It was for his own good you know. We wouldn't want him to aspirate (have food go into his lungs) and complicate things more. Being the doctor in the family, naturally the family asks me my opinion regarding end of life issues as he was wasting away in the hospital bed. I give them the same information I had always been given regarding the unavoidable downward spiral. This is a natural process right?
The family decided to let him go home on hospice as he was too weak for treatment of his hip fracture and lung cancer. I love hospice and felt good with this decision. When he got home, my aunt decided to go against the thickened feeds and give him what he wanted since she wanted him to be happy his last days. He just wanted some good country cookin'.
Being able to eat what he wanted more than made him happy. He was on his riding mower a week later mowing the yard! The guy that was about to die was riding his mower. Basically he was starving to death on hospital food! Yikes!
There are many lessons to be learned here. Listen to the patient. Feed the patient. Certainly one has to balance risks and benefits but why deprive a dying man some good food for risk of him dying sooner? If the risks are understood, then give them the choice. This doesn't mean to sneak food in without permission as you don't want to mess up any plans for procedures but really think about how you feel when you are hungry. I am going to be an old person with a chip on the shoulder. I don't like being told what to do and what to eat now so I imagine that will not change with gray hair. If anything, it will be stronger! We forget that our elderly still have their own desires and thoughts and are not children even if we want to treat them as such. If they have their cognitive abilities, then we need to include them in decision making.
My grandpa did die sometime after that but he died happily eating his eggs and grits and drinking coffee.