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Feature: SHARING

A little patience and some grapes

Carver, Martha L. MS, BSN, RN

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doi: 10.1097/01.NURSE.0000718912.55991.2d
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I'M CONVINCED THAT the grapes helped my mom. She wasn't feeling well after her discharge from the hospital, where she had been treated for an upper gastrointestinal bleed. While there, she had been diagnosed with lung cancer and was given less than 2 months to live.

She was weak and frail when she returned to the assisted living facility. She was uncharacteristically quiet and she needed nourishment.

Unfortunately, she didn't have an appetite. Everyone encouraged my mom to eat, but she didn't feel hungry. Once, someone encouraged her to drink a nutritional supplement. Reluctantly, she sipped the drink for a short time, then vomited. Because she was on hospice, my brother and I decided to let her eat whatever she wanted and not to worry if she didn't want to eat.

I appreciated the great care the nursing staff gave my mom. By offering her small portions of food, they avoided overwhelming her with large portions and making her feel as though she was wasting food she did not eat. They heard she liked ice cream, so they saved a container just for her and gave her a small dish every evening. Sometimes she would eat a few spoonfuls of ice cream when she could not tolerate anything else.

Knowing donuts were her favorite food, my daughters and I brought her fresh donuts every morning. She wouldn't eat any and commented they didn't even look appetizing. This was so unlike my mom and we were surprised by her lack of interest in food, even donuts.

Then my daughters and I started bringing in grapes and other fruit at mealtimes and placing them on the table for all to enjoy. My mom would say, “Oh those look good, but I just can't eat any. You can take them away.” But because the family enjoyed snacking on the grapes, they stayed on the table. A few minutes later, she would say, “Oh those look good. I will just try one.” She would have one or two grapes and then push them away.

Typically we remained at the table talking long after the other residents had finished their meals. A bit later, my mom would say, “Maybe I will have just one more grape.” After a while, she had eaten so many that I had to refill the bowl.

Although happy to see her start to eat, we were unsure why she preferred grapes over other foods, including her favorite donuts. Perhaps it was because she was dehydrated and the juicy grapes tasted better than donuts. Perhaps it was simply the fact that we lingered at the table, which provided an opportunity to eat them since they were handy.

Over the next few days, she started eating more grapes and even strawberries. Her appetite slowly returned and she began to look forward to her meals. No longer refusing her plate, she was almost impatient when the staff served other residents before her. At first, she ate small amounts, but the quantity increased over time.

What struck me as so powerful was the change in my mom from simply spending time with her, having conversations, and providing food without pressuring her to eat for the sake of eating. It amazed me to realize how such small things can go a long way to help. We didn't have to use the latest technologic advancement in order to improve her condition.

This experience helped me to grow in my understanding of healing. As a nurse, I knew my mom would not recover from her disease, yet she still experienced some healing. She died from cancer 7 months later, having lived far longer than predicted.

In those final months, I had my mother back. She started to act like herself even though she had some confusion. She was happy, smiling, and talking to people. The staff said that whenever she heard music, she started to dance! That definitely sounded more like my mom.

As I reflect on this time, I realize nurses help their patients in many ways, large and small. Although administering medications and treatments is very useful, our presence—simply being with our patients, taking their personal preferences into account, and listening—can be therapeutic. Interacting with the patient and family gives us insights into what is valuable to them.

We can and do help our patients live full lives, up to and including the time near the end of life. Sometimes all it takes is a little patience and some grapes.

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