Updated September 2026. Written and reviewed by the Lily Hospice clinical team.

Near the end of life, most people gradually lose interest in food and then fluids. This is a normal part of the body slowing down, and it usually does not cause hunger or suffering. Forcing food can cause choking. Offer small tastes if wanted, keep the mouth moist, and stay close.

For most families, this is one of the hardest parts. We feed the people we love. Food is care, memory, culture, faith and hospitality all at once, and when a mother who cooked for everyone turns her head away from a spoon, it can feel like losing her before she is gone. Some family members worry she is starving; others feel guilty for not trying harder. This guide explains why eating and drinking fade near the end of life, what the evidence says about feeding tubes and IV fluids, and the many things families can still do.

Why appetite fades

As a serious illness advances, the body’s systems slow down. Digestion becomes sluggish, the sense of taste and smell changes, and the body cannot use food the way it once did. MedlinePlus notes that people who have a very serious illness or who are dying often do not feel like eating. Later, swallowing itself becomes harder, first with solid foods, then with thin liquids. By the last days, most people take only sips or nothing at all.

This usually happens gradually over weeks, though it can be faster with some illnesses. It happens whether the illness is cancer, heart failure, kidney or liver disease, lung disease or dementia. It is not a failure of the caregiver, and it is not usually something a new food, a supplement shake or an appetite medicine can reverse at this stage.

Does not eating or drinking cause suffering?

This is the question families most need answered, and the honest answer is: usually not in the way people fear. People near the end of life generally do not experience the gnawing hunger a healthy person feels when they skip meals. The most common discomfort is a dry mouth, and that is something families can ease easily and often.

The National Cancer Institute advises that food and fluids “should not be forced on the person because it can cause discomfort or choking,” and suggests ice chips or swabbing the mouth and lips instead. Forcing food into someone who cannot swallow well can lead to coughing, choking and fluid going into the lungs, which can cause pneumonia. Accepting that the person has stopped eating is not the same as giving up on them. It is listening to what their body is saying.

Mouth care: the most useful thing you can do

When someone stops drinking, keeping the mouth clean and moist becomes the main way to keep them comfortable. The hospice nurse or aide will show you, and it quickly becomes second nature.

  • Moisten the mouth often. Use a soft mouth swab or a clean damp cloth dipped in water, every hour or two while awake, or whenever the lips look dry.
  • Protect the lips. A thin layer of lip balm helps prevent cracking. Ask the nurse which one to use if oxygen is in use.
  • Small ice chips or frozen juice can be soothing if the person is awake and can still swallow. Stop if they cough.
  • Keep teeth and dentures clean. Gently brush with a soft brush; remove dentures if they no longer fit well.
  • Let the nurse know about white patches, sores or a sore mouth, which can be treated.

Small tastes, on their terms

If the person wants to eat, offer what they enjoy, in the amounts they want. The National Cancer Institute’s clinical guidance notes that providing a small amount of food for enjoyment may be reasonable when a patient wants to eat. There are no diet rules at this point. Ice cream, a spoon of pudding, a sip of coffee, a taste of soup from a favorite restaurant, a sliver of birthday cake. Sit them up, go slowly, and let them decide when to stop. A person who only wants to hold a cup of tea and smell it is still having the tea.

Some practical tips:

  • Offer small portions on a small plate; a full plate can feel overwhelming.
  • Soft, moist foods are easier: yogurt, applesauce, mashed potatoes, soup.
  • Have the person sitting as upright as possible, and for a while afterward.
  • If coughing or choking starts, stop and call the nurse, who may suggest thickened liquids or a different approach.

Feeding tubes and IV fluids near the end

Families often ask whether a feeding tube or IV fluids would help. It is a fair question, and it deserves a real answer rather than a quick yes or no. The decision belongs to the patient, or to the person speaking for them, together with the care team.

What the evidence shows. In the last weeks and days of life, the research does not show that artificial nutrition or hydration helps people live longer or feel better. The National Cancer Institute’s clinical summary states that artificial nutrition is “of no known benefit” at the end of life and may increase the risk of aspiration and infections. It describes a randomized trial of people in home hospice in which IV-type fluids under the skin made no difference to survival, symptoms, quality of life or delirium compared with a placebo amount. It also notes that more IV fluid in the final days is linked to more of the gurgling secretions sometimes called the death rattle.

What the evidence does not say. It does not say that anyone who wants fluids is wrong to want them. The same NCI summary cautions clinicians to keep an open mind, recognizing that some patients and families value hydration and that the harm in some cases may be small. For a few people, particularly earlier in an illness or with certain conditions, fluids or tube feeding may fit their goals. Those are conversations to have with the hospice doctor and nurse, not decisions anyone should make alone at 2 a.m.

What to do. Ask the team: what would fluids or a tube do for my person, specifically, right now? What might they cause? What would they want, if they could tell us? If a feeding tube is already in place, the team can talk through slowing or stopping feeds when they begin to cause discomfort. You are allowed to change your mind.

Dementia: a slower, different path

In advanced dementia, problems with eating often come on over months: forgetting to eat, pocketing food in the cheek, coughing with drinks, and eventually difficulty swallowing. These changes are part of the disease itself, and they are often a sign that it has reached its later stage.

The American Geriatrics Society does not recommend feeding tubes for older adults with advanced dementia, noting that tube feeding can cause harm, including worsening pressure ulcers, and that careful hand feeding in a calm, quiet setting is the better approach. Careful hand feeding means sitting with the person, offering small spoonfuls at their pace, and stopping when they signal they are done. It keeps the pleasure of taste and the closeness of being fed by someone who loves them. Our page on hospice care for dementia explains how the team supports families through this stage.

Food, culture and faith

In many families, and in many faiths, food carries deep meaning. Offering food may be a religious obligation, a sign of respect, or the last way a daughter knows how to care for her father. Some traditions have strong beliefs about nutrition and hydration at the end of life. These feelings are real, and it is okay to feel them.

The hospice chaplain, for families of any faith or none, and the social worker can help families talk through what their tradition teaches and what the person would want. Sometimes an imam, priest, rabbi or pastor from the family’s own community joins the conversation. There is often room to honor both the tradition and the person’s comfort: a sip of water with a blessing, a taste of a holy day dish, a family meal held in the bedroom so the person is part of it even if they do not eat.

What families can do instead

When feeding is no longer the way to care, many families feel lost. Here are other ways to give the same love:

  • Sit close and hold a hand. Presence is its own nourishment.
  • Offer mouth care. It is gentle, intimate and genuinely comforting.
  • Massage hands or feet with lotion, if they like touch.
  • Read, sing or play music they love. Hearing may remain even when they cannot respond.
  • Bring the kitchen to them. The smell of coffee, bread or a family recipe cooking can be a comfort.
  • Tell stories. About the meals they made, the holidays, the recipes you want to keep.
  • Rest. Your own meals and sleep matter too. Respite care exists for exactly this.

For how eating changes fit into the larger picture, see signs death is near. For the daily rhythm of caregiving, see what the family does day to day on hospice.

When to call the hospice nurse

If your person is on hospice, call the hospice line, not 911, if:

  • They cough or choke when eating or drinking
  • Their mouth looks sore, cracked, coated or bleeding
  • They seem uncomfortable, restless or in pain
  • They have had no urine for many hours, or their belly is swollen or hard
  • You or other family members are struggling with the decision about food or fluids and want to talk it through

At Lily, a real person answers 24 hours a day; see what happens when you call hospice at night. If your person is not on hospice and has stopped eating, call their doctor, or call us to talk it through. Steady weight loss and eating very little can be one of the signs that it may be time to ask about hospice; see signs it’s time for hospice.

Common questions

How long can a dying person live without food or water?

It varies widely with the illness, the person’s condition and how much they are still sipping. Some people live days, others longer. The hospice nurse can tell you what they see, but no one can predict an exact time.

Is my loved one starving to death?

No. When someone is dying, loss of appetite is usually caused by the illness and the body slowing down, not the other way around. People near the end generally do not feel hunger the way a healthy person would.

Are they thirsty?

A dry mouth is common and can be uncomfortable. Frequent mouth care with swabs, lip balm and small sips or ice chips if they can swallow is the best way to relieve it.

Should we ask for IV fluids?

Research in people near the end of life has not shown that IV fluids help them live longer or feel better, and more fluid in the final days is linked to more throat secretions. Talk with the hospice team about what fluids would do for your person specifically.

Would a feeding tube help someone with advanced dementia?

The American Geriatrics Society does not recommend feeding tubes in advanced dementia and supports careful hand feeding instead. Discuss the options and your person’s wishes with the care team.

What if they ask for food they are not supposed to have?

Near the end of life, comfort usually matters more than diet rules. Ask the nurse, but a small taste of a favorite food is often fine if they can swallow it safely.

Is it wrong to stop offering food?

No. Keep offering small tastes when they are awake and interested, and stop when they turn away or cannot swallow. Following their lead is a form of care.

My family disagrees about this. What can we do?

This is common. Ask the hospice social worker or chaplain for a family meeting with the nurse, where everyone can hear the same information and talk about what your person would want.

Hospice isn’t giving up. It’s showing up. If you are in Oakland, Macomb or Wayne County, call (248) 955-5100. A real person answers, 24 hours a day.