Mom, youve got to eat. Why, Im not hungry. How are you going to get better? Silence filled the seconds that followed. Silence that spoke louder than words. She wasnt trying to starve herself. Cindys Mom just wasnt hungry. Her body had begun to shut down and food made her feel bloated. She didnt want to eat. She wasnt hungry and her body didnt need the food. Not only that, forcing herself to eat seemed violent. At the end of life our body doesnt always need food for energy. The importance of food at this point is not for nourishment but to celebrate days. It still has great symbolic value. It speaks of home, traditions and friends. Small amounts of appealing food eaten while in bed with family talking and laughing nearby is still a feast. In his book Last Rights, Stephen P. Kiernan quotes Dr. Joanne Lynn of Americans for Better Care of the Dying in Washington, D.C.: In our system, it is easier to get open heart surgery than Meals on Wheels, easier to get antibiotics than eyeglasses, and certainly easier to get emergency medical care aimed at rescue than sustaining, supportive care. Kiernan points to an article in the Annals of Internal Medicine quoting This elevation of the science of medicine above the humanity of the patient is a serious problem that cannot be resolved without changes in the organization and culture.. In our family or medical systems it is some times easier to insert a stomach tube and introduce artificial nutrition into a loved ones body in a hospital than to wait, watch and provide nutrition that comes from touch, conversation and presence. I remember some sage advice my mother gave me as my children were growing and didnt want to eat. They will eat when they are hungry. Referrals for hospice care are given by physicians, nurses, friends, neighbors, the patient or family members. Call 1-877-324-1686 to learn more about High Peaks Hospice or visit our web site at www.highpeakshospice.com .