At Angela Hospice, the care team is made up of professionals who specialize in various aspects of hospice care, and one key member is Kelly Duquette, a compassionate Dietitian who works closely with patients and their families to navigate the complexities of nutrition during their end-of-life journey. Kelly’s role goes beyond just providing meals—it’s about making thoughtful, ethical decisions to ensure the comfort and dignity of every patient she cares for.
Helping Families Navigate Change
For many families, the journey through hospice care can be a confusing and emotional time, especially when it comes to understanding what their loved one needs nutritionally. Kelly plays an integral part in educating and reassuring families.
“Many families will have questions about whether they should still feed their loved one or if certain foods should be avoided,” she explained. “I help guide them through these decisions by explaining how the body naturally changes in this stage of life.”
As the body shuts down, there is less ability to process food. Organ systems are slowing down, and less is being absorbed. In these cases, it’s crucial to monitor how much food and fluids are being taken in, and adjust based on what the patient can tolerate. Nutritional considerations for a hospice patient should always be done carefully, with respect to the individual’s needs and preferences.
Understanding Nutrition in Hospice
Dietician Kelly
Hospice care is unique in that its focus is not on curing illness, but on providing comfort during the final stages of life. Kelly is committed to helping patients and their families understand the importance of adjusting nutritional needs as the body naturally slows down.
“When people are near the end of life, food can sometimes cause discomfort,” Kelly explained. “Slower digestion and less physical movement mean that what was once nourishing can now be hard to tolerate.”
Many families struggle with the idea of not providing traditional nourishment to their loved ones, as food is often seen as a way of expressing love and togetherness, , as well as a necessity of healing. However, Kelly emphasizes that when someone is nearing the end of life, it is not about healing, so the focus shifts to comfort rather than nourishment.
Addressing Ethical Dilemmas in End-of-Life Nutrition
One of the more challenging aspects of Kelly’s work is balancing the ethical dilemmas that arise. For example, a family member may insist on certain foods or interventions, despite the fact that the patient can no longer tolerate them. Kelly works closely with each family, advocating for the patient’s choices and ensuring that any decision is made with dignity and respect for their wishes.
“I’ve been on the other side of the table,“ Kelly shared, reflecting on her own experience caring for a family member in hospice care. This perspective gives her a deep understanding of the delicate emotional dynamics at play during this time.
“We have to provide the food and fluids in a way that the patient can tolerate.”
It’s a constant balancing act of providing comfort without causing distress, understanding that every patient is different and their needs are unique.
A Collaborative Approach to Care
For patients in Angela Hospice’s Livonia Care Center, Kelly works alongside the talented Chef Ron, whose energy and passion for food helps create a comfortable environment for patients.
“Ron and I often run to the store to get whatever anyone wants. If a patient asks for something, we make it happen,” Kelly said with a smile.
The Care Center is equipped with a full commercial kitchen and on-site chef. All of the meals provided to patients are prepared in house. This ensures that patients have a variety of options to make meal times as enjoyable as possible, whether it’s a favorite comfort food or a special treat, like “Nilla Wafers and cake,” a request Kelly recently received from a patient.
At Angela Hospice, the care team is always working together, and Kelly’s role often includes collaborating with others about the texture of meals and the most appropriate strategies for accommodating patients’ needs.
The Importance of Dignity and Choice
One of Kelly’s guiding principles is maintaining the dignity of each patient. Whether a patient is asking for something sweet like apple pie and soda, or has specific cultural or dietary needs, Kelly ensures that their wishes are respected.
“We support patients’ choices and give them what brings them joy and comfort, even if it’s not the most ‘nutritious’ option,” she said.
In fact, Kelly often uses what she calls a “liberating diet” approach, helping patients enjoy the food they love during their last days. In a hospice setting, these moments of joy can be incredibly meaningful, and Kelly’s understanding of this helps her guide families through what can often be a difficult process.
Navigating the Emotional Landscape of Hospice Care
The emotional aspect of hospice care is perhaps one of the hardest elements to navigate for both families and the clinical team. Kelly is sensitive to this stress and works hard to ease the anxieties of both patients and families.
She explains, “Hospice is not the same as a hospital setting. Here, it’s about listening to the patient’s story, understanding where they’re at in their journey, and meeting their needs with compassion.”
Continuing Education and Ethical Practice
Kelly’s dedication to providing the best care is backed by her commitment to ongoing education. As a Registered Dietitian, she is constantly expanding her knowledge, attending conferences, and staying up-to-date on the latest research in the field.
“You can never stop learning, especially in hospice care,” Kelly says. “The needs of each patient are so unique, and you have to be adaptable.”
Through her work, Kelly helps families navigate the complexities of hospice care, providing education and guidance to ensure that each patient’s nutritional needs are met in the most respectful and caring way possible. Her passion for this work and her willingness to advocate for her patients and families makes her an invaluable member of the Angela Hospice team.
Additional Resources:
https://www.todaysdietitian.com/newarchives/082508p68.shtml
Support at the End of Life: A Critical Decision By: M. Patricia Fuhrman, MS, RD, LD, FADA, CNSD
Today’s Dietitian. Vol. 10 No. 9 P. 68. September 2008 Issue.
https://www.hrrv.org/blog/the-role-of-nutrition-hydration-at-the-end-of-life/
The Role of Nutrition & Hydration at the End of Life
Hospice Red River Valley
https://hospiceofhuntington.org/get-help/tips-from-the-dietitian/end-of-life-nutrition/
End of Life Nutrition
Hospice of Huntington
