Eating and drinking are a major part of many people’s lives, particularly at times of the year when we are celebrating. When much of the focus of celebrations revolves around food, any problems with eating can be heightened. Caroline Quilty is Royal Trinity Hospice’s Senior Dietitian and has put together this guide for those preparing meals for a patient or for patients who may live alone.

When someone has cancer or another life-limiting illness like lung disease, heart failure or a neurological condition, their appetite and ability to eat changes.

Factors that can affect this can be that food doesn’t taste the same anymore due to the effects of chemotherapy or radiotherapy, or feelings of nausea, breathlessness or fatigue, which can make preparing and eating meals difficult or tiring. If someone is feeling low in mood, their appetite levels can also be affected and all at a time of year when there can be a real pressure to enjoy yourself.

Portion size is key

If you are celebrating Christmas and will be the Christmas Day cook, start by talking to the person you are cooking for about the types of food they might like and try offering small portions to begin with. Normal portions may look overwhelming and be off-putting. Try:

• Serving a small portion on a smaller plate or bowl
• Spreading 3 meals into 5 or 6 small snacks for example, split up lunchtime meals into a bowl of soup at midday and then a small dessert like a thick and creamy yoghurt mid-afternoon.
• Suggest to the person they can have whatever foods they can manage at any time of the day e.g: breakfast cereal at teatime, or switch the main meal to earlier in the day.
• Foods that previously have been very enjoyable may now be unpalatable so be prepared to try something different. If your partner had a really sweet tooth, they may now prefer savoury foods or bland flavours. 

“Don’t be surprised if the person you are caring for can only eat very small amounts or doesn’t want anything at all at mealtimes. This can be very upsetting as you may feel that there is nothing that you can do for them but if the person feels pressurised to eat, that may unintentionally make them feel even worse. Take the pressure off mealtimes by offering small, tasty snacks for the person to help themselves to when they feel able to.”

Making adjustments to the day

Although many of us have our own traditions around eating at Christmas, there are no rules, and it may be easier to try doing things a bit differently for a change.

If your loved one gets increasingly tired as the day progresses, why not consider having Christmas lunch in the middle of the day rather than waiting till the evening? Or change the focus to having a festive breakfast and having tiny “taster sized” portions of the main meal later on.

Being aware that cooking smells may be off putting for someone experiencing nausea. Opening the windows when cooking, getting some fresh air before you eat or offering foods that are cold instead of a cooked meal eg: crackers and cheese may all help in these circumstances.

If you are travelling with your loved one and won’t be at home for Christmas Day consider taking a small lunch box of snacks with you, so they have these ready and can eat when they want to.

Snack packs and cold options are easier wins 

Catering for yourself? 

If you don’t have anyone who does the cooking for you, look for:

• Ready-made options in small or one-person portions, which lots of home food delivery companies now do and with some good choices out there too!
• Ready-made festive mini portions e.g. mini desserts, party and cocktail size savoury snacks which can be found in most supermarkets.

Go with how you feel and don’t put too much pressure on yourself! If you just want a couple of “pigs in blankets” with a small helping of buttery mashed potato for Christmas lunch that is absolutely fine!

Enjoying a drink

If you drink alcohol, a glass of your favourite drink may help perk up the appetite for instance a G&T before your meal or a glass of wine with your meal.

Check with your doctor about whether it’s okay to drink alcohol with any medication that you are on too.

“It’s important to remember that if your loved one has a poor appetite it really is something that they can’t help – they are not being awkward, but they can be overwhelmed by the pressure to eat. As hard as it can be, take a step back; listen to how they are and what they want to eat and be prepared to adapt if you can.”

Trinity’s dietetic service is available to Royal Trinity Hospice patients staying on our inpatient unit or living at home. Support and advice are available face to face, over the phone or video call. Ask your nurse, therapist or hospice doctor for a referral.

Access our Living Well Dietetic Service