Most of us enjoy our meals without worrying about food texture or the consistency of liquids. Different cultures emphasize the role of food in promoting health and longevity. However, as we approach the end of life, our appetite diminishes, and swallowing becomes challenging. This can lead to difficulties in consuming various foods and drinks.

Changes in Eating Abilities

  1. Reduced Appetite and Swallowing Issues As individuals near the end of life, they often experience decreased thirst and appetite. Additionally, swallowing difficulties can arise, ranging from trouble with chewing to forgetting how to swallow. Despite being minor in some cases, these issues can lead to significant energy expenditure during eating.
  2. Progression of The dietary texture for terminally ill individuals undergoes a progression:
    • Regular Texture: At this stage, patients can consume a wide variety of foods, regardless of hardness, softness, or consistency.
    • Thin Liquids: This includes water, milk, soda, etc.
  3. Indicators for Texture Modification Certain signs suggest the need to alter :
    • Food Pocketing: Patients retain food in their mouths, not swallowing but moving it to their cheeks.
    • Swallowing Troubles: These might lead to choking, spitting out food, or a combination of both.

Progression of Texture Changes

  1. Diet Texture Range The range of diet texture changes for the terminally ill follows a trajectory:
    • Start: Regular texture.
    • Next: Mechanical soft texture (same guidelines as moving from regular to mechanical soft are used).
    • Following: Puree texture.
  2. Liquid Consistency Progression For liquids, the following steps can be taken:
    • Thin Liquids: As a starting point.
    • Nectar Thick: If coughing occurs within 15 to 30 minutes of drinking thin liquids.
    • Honey Thick: If nectar thick liquids still pose problems.


Understanding the evolving dietary needs of terminally ill individuals is crucial. As their appetite diminishes and swallowing becomes challenging, adjustments in food texture and liquid consistency are necessary to ensure comfortable and safe consumption.


Mechanical Soft Diet: How It Works and Recommended Foods

Using thickened liquids for safer swallowing

Carer information: Eating and drinking at end of life

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