
I'm a hospice chef and most people at the end of their life have the same final meal request
Spencer Richards, chef at Sobell House Hospice in Oxfordshire, makes it his mission to ensure patients' last meals are made with love and care.
He said: 'My own philosophy is that there can be no greater privilege as a chef than serving someone their final meal.
'Recently a 21-year-old patient didn't connect with anything on the standard menu. He was young and didn't like the usual options, so we talked and he liked street food, so we made that happen.'
The chef also recalled another patient, a woman who turned 93 during her stay in hospice, and the dish he made that brought her to tears.
'She hadn't had the most traditional home life, and birthday cakes were never really part of it. When we surprised her with one, she was in tears. She was absolutely over the moon.'
It may come as a surprise that birthday cakes are a popular request from patients at the end of life - particularly those in their 80s or 90s.
Birthday cakes bring up lots of fond memories for many people, but cakes and desserts also tend to be more palatable for hospice patients who may have been through intense medical treatments.
Spencer said: 'They're small things, but especially for people who've been isolated or are feeling lonely, they mean a lot.
'Food at the end of life is as much about adapting as it is about cooking. Patients often lose the ability to swallow or taste buds change due to medicines and treatment such as chemotherapy.
'Many in the hospice become sensitive to salt, so we moderate that. And we find that often people with cancer get a sweet tooth.'
A common side effect of chemotherapy for cancer patients is a metallic taste that lingers in the mouth, which may make savoury foods unappealing.
Vomiting, difficulty swallowing and painful mouth ulcers are also a common side effect of cancer treatment, causing food to become unappetising.
However, sweet foods that are soft can offer patients some comfort as well as provide nourishment.
As well as birthday cake, Spencer takes inspiration from classic French desserts like panna cotta, crème brûlée, and crème caramel - all soft, easy-to-eat desserts that are familiar and delicious.
Some people can only tolerate jelly or ice cream, and in these instances, Spencer makes sure the dish is presented in a thoughtful manner.
'We don't always know at the time what it means. But we hear back later - families come back months afterward, just to say thank you,' he said.
People approaching the end of their lives may find themselves eating and drinking a lot less than before, even if they have always taken pleasure from enjoying food.
In hospice care, doctors, nurses and carers are better able to look after the person's needs and ensure they can eat and drink as comfortably and pleasurably as possible.
Spencer recalled a family who lost a loved one earlier in the year who returned to the hospice on Christmas day with food for the staff as a gesture of gratitude.
Spencer said it's these moments that remind him what his work is really about.
'At this stage in my career, I want to give back,' he added.
'Food is a powerfully emotive medium - it can summon childhood memories and create new lasting ones. That's what we do here.'
Sobell House is jointly funded by the NHS and the Sobell House Hospice Charity, which raises £4 million annually.
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