Nutrition in Palliative Care – More than just ‘Tea and Sympathy’

Food, exercise, lifestyle and the external environment

We’ve known since Ancient times that food, exercise and lifestyle plus the external environment in which we live, have a definite influence on our health. This has now been verified beyond any doubt through epidemiological research and experiments. Good nutrition helps us to have a feeling of well-being, preserve and increase our strength and energy, maintain a healthy weight and retain adequate stores of useful nutrients, tolerate treatment related side effects, decrease the risk of infection and heal and recover quickly.

Nutrition in palliative care

In palliative care, good nutrition can enhance recovery, when healing is possible. Poor nutrition on the contrary results in poor resistance to infections, impaired wound healing, increased susceptibility to pressure ulcers and fatigue. Good, nutritious food can also contribute to the patient’s overall sense of wellbeing. A drop in essential amino acids or glucose can adversely affect the nervous system and behaviour. Last but not least, food has a major psychological and social significance.

Personalised nutritional advice

Each one of our patients is an individual and so they need to have personalised advice. If they live alone they will need practical advice on how to prepare nutritious food when, at the same time, they can experience overwhelming fatigue. Practical advice on where to get good ‘meals on wheels’ can be extremely important for them. Their individual preferences need to be taken into account: if they like eating meat and two vegetables, they may ignore dietary advice to eat, for example, fish. On the other hand, a serious illness often leads people to make radical changes to their lifestyle in an attempt to become stronger.

A patient’s story

When Phil who was only 45 found out he had metastatic lung cancer, he turned overnight from a successful consultant physician to a patient with a life-limiting condition. During an admission to hospital for a severe infection, he lost 2 stones of his body weight. He was started on chemotherapy, which resulted in severe nausea and vomiting. These symptoms were made worse by anxiety and fear, which also affected his appetite. More than a year later, he was strong and receiving treatment for disease recurrence to the mediastinal lymph nodes.

He talks openly in this video about the physical and emotional impact the disease had on his life. One of the most significant pieces of advice he said he received during the period that chemotherapy had changed his sense of taste and smell and wiped out his appetite was, to eat porridge with honey and bananas. For a while, this was what he had for breakfast, lunch and dinner.

Furthermore, exercise played a significant role in his rehabilitation. Armed with his scientific background and inquisitive mind, he sought additional ways to support himself, increase his chances of survival and improve his quality of life.

He believed that ‘good food’, regular exercise, meditation, Qigong, hypnotherapy, laughter and love, combined together will help him. And I had no reason to doubt that. I supported him through his decision to change his habits and to follow ‘an anti-cancer diet and lifestyle’.

Hippocrates and our responsibilities

We approach each person with an understanding that they are not just body, but also mind, emotions and soul; they bring their personal history, belief system, hopes and cultural background. As healthcare practitioners we seek to help the individual patient, showing compassion and care. 

To use Hippocrates’ words:

Life (ours and our patients’) is short, the Art of Healing is long, the Opportunity to help our patients is fleeting, Experiment is sometimes treacherous and Judgement can be difficult

Michelangelos_hand



 

Olympic Gold Diet

My latest article and recipe in the Help the Hospices Information Bulletin

In Ancient Greece it was forbidden to export figs (called ‘syco’ in Greek). Furthermore, people were encouraged to expose those who secretly exported figs for profit. Some used this as an opportunity to falsely accuse others of this crime, to take personal revenge. This is where the modern word sycophant comes from.

Eleni’s article-Hosp Info Bul Jan 2012