Get real

I was talking, as always, to a neighbor about someone with terminal cancer. Her concern was that he was getting too thin. His children did not want him to eat any junk food, especially sweets because they weren’t healthy foods.

I have heard this comment before from the families of patients or residents. OK folks, let’s get real. I am the first to advocate good eating habits, safe foods, avoiding excess. However, there does come a time for common sense. If I have someone who is not eating anything, anything they will eat is a good thing. I am not talking about feeding someone with an eating disorder. That is a different problem. I am talking about an adult or child who is too ill to have an appetite. Time, in this case, is not your best friend. The longer that someone goes without eating, the harder it is to get started again. The body is built to give up appetite when food no longer becomes available, for whatever reason.

This is what I call “The Good Calorie Diet,” meaning any calorie consumed is a good calorie. Yes, excess sugar increases inflammation, and too much fat can clog arteries. Operative words are “excess” and “too much.” If someone is receiving chemotherapy, although I never suggest trying favorite foods (enough times barfing it up will change any favorite into a “never again” food), I will suggest adding butter (better than margarine), cream, and sugar to add calories to usual foods.

Evaporated milk is great for making pudding, adding to mashed potatoes or cream of wheat.

Should cancer therapy be unsuccessful, I really do not care what my patient eats, as long as they eat something. Remember that food has a soothing effect and can produce good memories, which might make them happier. Also, too much sugar and fat can make one fat, but at this point, does the person really have that much time to care?

I have developed the same belief with those residents or patients who are running at or crossing over the century mark. Typically, although I would love for them to have a great appetite and eat lean meats, fresh fruits and vegetables, etc., I am generally grateful for whatever I can get them to eat. Brownies after breakfast? Sure. Snack on chocolate between meals?

It used to bother me, but I have watched too many die over the years. Not eating leads to malnutrition, which is never pretty to watch or experience.

I do routinely recommend a good multivitamin and mineral supplement, but other than that, I have come to the belief that the centenarians or others have earned the right to eat what they choose. After all, do I actually expect them to be around in the next five to ten years to experience complications? If they are, the issue can be re-visited. If not, food provides pleasure and in the end stages of life, is it too much to give?