One of the major milestones in serious illness occurs when a patient stops eating and drinking. We're talking about why it happens, how to cope with it, and what it means.  When someone with a serious illness moves toward death, he might begin to have difficulty taking in food or fluids.  It's a hard thing for those who love them to watch.  Patient might refuse food, or have difficulty chewing or remembering to swallow.  It's a sign of hope and thriving to be able consume food, so when that ability stops it's a major milestone in the disease process.  Family members and caregivers might offer snacks or favorite foods to encourage a patient's appetite.  That doesn't change what's happening, or how the disease will progress.  Because the human body naturally knows how to die, forcing food either by mouth or using a feeding tube can cause problems like choking, aspiration, or pneumonia.  Intravenous fluids given to hydrate the patient can overload the patient's circulatory system and cause respiratory distress.  Dehydration is a natural part of the dying process and can even give the patient a feeling of wellbeing.  Hospice teams should recognize and respect how difficult this milestone is for caregivers.  Gentle education and honest discussion will help them to navigate this step in the trajectory of a serious illness. To find more podcasts from The Heart of Hospice, visit theheartofhospice.com.  We’re here to support your hospice journey, with support and encouragement. There’s information on advance care planning, self care, caregiving, and the basics of hospice philosophy.  No matter where you are in your hospice journey, The Heart of Hospice is here to help.