End of life: the importance of pleasure

The first wine bar in palliative care in France opened in September 2014 at the University Hospital of Clermont-Ferrand. Today, few people on the verge of death are entitled to the small pleasures of everyday life that can be a glass of wine, a home-cooked meal or a beautifully laid table. Yet, good food is a symbolic ritual and has real benefits on morale.

Ségolène Poirier

The stay in palliative care - with an average duration of 17, 6 days (June 2013, Ministry of Health) - is the last step in the life of these patients. It is to put a little sweetness in this period more than shocking, that some establishments offer to patients meals prepared by chefs or students in the hotel industry, or develop studios to bring them closer to their family. The latest project, a wine bar of nearly 260 bottles will open this month to the palliative care of the University Hospital of Clermont-Ferrand.

By conducting her study "End of Life: Pleasures of Wine and Foods", socio-anthropologist Catherine Le Grand-Sébille observed two trends in end-of-life care in the hospital. On the one hand, the influence of medicalization which limits food to nutrition and banishes alcohol, on the other, demedicalisation and the freedom to eat and drink according to one's preferences. Patients are then considered to be residents. Everything is done so that the last days of their lives do not differ too much from those before entering the hospital. "When critical illness is forced to adapt to the hospitable rhythm, it is important to maintain habits, like to eat what we like for example, "explains Catherine Le Grand Sébille.

Being surrounded by your family

Meeting around a good meal, with family or friends, it is also an opportunity to interact and share. This ritual allows the patient to maintain a social life. But it is equally important for those close to them who are also going through this difficult ordeal, as the socio-anthropologist has observed through his study. "No longer eating, no longer appreciating "we loved before, closer to the end of life, it is lived with sadness by family and friends."

It is especially to avoid these situations, that the institutions promoting the demedicalization of the End of life, allow loved ones to bring homemade dishes. "Especially when they require a know-how and ingredients difficult to find on site," noted Catherine La Grand Sébille.

Keeping the senses on the alert

No longer drinking wine, no longer enjoying your favorite dish, and it's the sensory pleasures that are slowly disappearing.The taste and smell of the sick are no longer stimulated and some memories become more vague. "Does not the pleasure of taste build these stories for oneself to share with others?" questions Catherine Le Grand Sébille. The olfactory and taste memories are those that can bring back memories of childhood, allow our imagination to travel or feel at home. Allowing these men and women on the verge of death to rediscover the flavor of life is a nice way to give them a softer end.

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