K.A. Merrill1, A. Cammer2, C. Lengyel1
1Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB,
2College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK

There is minimal extant literature surrounding the role of food in death and dying, specifically within long-term care (LTC) homes, despite the cultural significance of food throughout all stages of life and at end of life (EOL) in particular.

To examine dietitian perspectives of ways in which food assists and complicates a comfortable death for residents in LTC facilities.

Semi-structured qualitative interviews were developed, focussing on EOL care experiences of registered dietitians (RDs) in LTC settings. The interviews were conducted virtually with 30 Canadian RDs in June/July 2021 using secure WebEx platform. The interviews were transcribed verbatim, analyzed for themes following a thematic analysis framework and verified.

Six main themes were identified. (1) Shifting food and nutrition goals for residents at EOL from meeting nutritional needs and prolonging life to modulating pain and discomfort in attempts to provide a comfortable death; (2) Food as a means for families to grieve/cope; (3) Role of food as complex and challenging for grieving families to understand, (4) Nutritional care is dynamic and individualized; (5) Bodily autonomy and patient dignity are necessary but may be unnoticed; and (6) Food is often overlooked in the EOL care plan created by health care professionals.

Food and nutrition at EOL in LTC homes is multi-faceted and complex. The role of food in death and dying is multifaceted, ranging from a means to comfort EOL patients and their families to minimizing pain and suffering. Currently, these roles are not adequately reflected in the scientific literature, or in many EOL policies and procedures.

Dietitians and health care teams need further training on comfort care strategies and assisting with families understanding of the involvement of food and nutrition in the dying process.

University of Manitoba, University of Saskatchewan and Canadian Frailty Network