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Caregiving With Confidence

Solving Mealtime Stress

Caregivers are vital to keep the cancer patient well-nourished. By Michelle Johnston-Fleece

One common side effect of cancer and its treatment is a diminished appetite or an outright inability to eat. This can be worrisome for caregiver and patient alike, because patients need nutrition to fight illness and heal. What’s more, by not being able to enjoy communal meals, the patient may feel isolated from family and friends.

Michelle Johnston-Fleece / Photo by Anthony DiPietro
Though eating may remain tricky for a time, there are things you as a caregiver can do to help.
Mitigate the Physical Effects 
of Cancer and Its Treatment
Mouth sores from radiation therapy and wounds from surgery can make eating difficult. When such physical side effects affect eating, ask your loved one’s oncologist for advice. Nutritional supplements, pureed or minced food, a liquid diet or even a feeding tube can help the patient receive adequate nutrition.
Prepare Meals Carefully
Cancer treatments can weaken a patient’s immune system, making it harder for the body to fight infection or foodborne illness. It is critical that food the patient eats is properly handled, cleaned and cooked. Check expiration dates, wash your hands frequently before and while preparing food, and use a thermometer to ensure that meats are thoroughly cooked. Avoid serving uncooked or undercooked meat, seafood and eggs, including sushi and eggs with soft yolks.
Increase the Impact of Meals
Oncologists often tell patients on treatment to eat whatever they want. That’s because patients’ bodies need enough calories and protein to fight cancer and repair themselves. You can help by serving bigger meals when the patient is most hungry. Also, try to pack in extra calories: You might put cheese on sandwiches, add butter to vegetables, or offer a nutritional supplement drink. (Always ask the oncologist or nutritionist for guidance about foods the patient should eat or avoid.) Finally, be open to serving unusual foods at unusual times. If a loved one wants ice cream at 7 a.m., try to make it happen!
Reduce Mealtime Stress
Because anxiety, nausea and vomiting make it difficult for a patient to eat, mealtime may feel stressful. To reduce that stress, avoid pressuring a loved one to eat. Instead, make food that is as appetizing as possible, and offer space and time. These steps, along with gentle reassurance that eating difficulties are normal, may help the patient to eat more.
Consider Avoiding Favorite Foods
Though it may seem counterintuitive, you might want to avoid serving the patient’s favorite foods. Patients may associate foods eaten during treatment with therapy’s side effects, such as nausea, so those old favorites could end up triggering a negative physical response post-treatment.
Enlist Help
Don’t go it alone. Other friends and family members can prepare and deliver meals for a loved one—and you. Websites like and help with the scheduling. If you don’t have a strong support network nearby, look into local nonprofit organizations, such as God’s Love We Deliver (in the New York City area) and Project Open Hand (in the San Francisco Bay area), or a national company, like Meals to Heal, which provide meal services for sick people. And don’t forget the patient’s nutritionist, nurses and oncologist, who can help you anticipate eating difficulties and offer tips to manage them.
Food and nutrition are fundamental for the patient’s healing and connection with others. As a caregiver, you can help a loved one get what he or she needs to nourish the body and spirit.
MICHELLE JOHNSTON-FLEECE was the primary caregiver for her husband, Matthew Fleece, who died in 2004. Now a patient advocate, she is the director of state initiatives for the Cancer Support Community’s Cancer Policy Institute.


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