Nutritional options important part of palliative care

I came across an interesting discussion recently about whether Ensure and other nutritional beverages marketed towards older people are really the best option.

Despite being a geriatrician, I *don't* like Ensure

It's an expensive chemical milkshake laced w/ empty calories that can cause cavities if not careful

Would you want real food if you drink a heavy milkshake before every meal?

Gaining numeric weight ≠ Delaying death

— Aroonsiri (June) Sangarlangkarn MD MPH FACP (@AroonsiriMD) February 10, 2022

The discussion that followed the geriatrician’s perspective included interesting pros and cons. It made me think about my parents’ experience with the beverages. My father had never been a fan of milkshakes or similar beverages, but he seemed to enjoy the Ensure drinks, so I would ship cases of them to the memory care center where he spent the last year of his life. My mother existed on Ensure for the last month or so of her life. I have regrets about that, wishing I had taken time to make her something that she would have enjoyed more.

This is why I’m such a strong believer in expanding inpatient hospice and providing more robust home hospice care. As the sole caregiver for my mother at the end of her life, things like whipping up something delicious for her to eat didn’t cross my mind because I was so busy focusing on the “important” things, like her pain medication, treating her bedsores, etc. While I managed to mainly keep her suffering to a minimum, there was no joy in her final weeks.

Those with dementia may struggle with solid food as they enter the final stages of the disease, so liquid forms of nutrition may become a necessity. Homemade smoothies, puddings and milkshakes may interest those who have grown tired of the commercial products. If you can, consult with a nutrition specialist or dietitian about tasty, safe options for your loved one. Bringing loved ones small moments of joy can also lift the spirits of family caregivers.