Interviewing Those Who Just Lost Their Loved Ones: An Innovative Method to Introduce Palliative Medicine to Medical Students (704)

Abstract

Objectives 1. Discuss a pilot study of taste changes amongst hospice in-patients with advanced cancer. 2. Review the frequency of both subjective and objective taste changes and the relationship between them. 3. Assess the influence of taste changes on dietary intake. Background. Alterations in taste sensation may cause poor dietary intake and malnutrition which likely reduce quality of life (QOL). Identifying different taste abnormalities can help us understand eating difficulties. Research objectives. We conducted a pilot survey study of taste changes amongst hospice inpatients with advanced cancer. We examined the frequency of both subjective and objective taste changes and the relationship between them. We also assessed the influence of taste changes on dietary intake. Methods. We recruited 15 consecutive hospice in-patients. On Day 1, patients were questioned about subjective taste changes, food preferences, and daily dietary intake using a structured questionnaire. A 27food item checklist provided food preferences based on the four basic taste senses. On Day 2, a forced choice 3-stimulus drop test was performed for objective taste evaluation. Pearson’s correlation test identified the association between subjective and objective taste changes. Results. There were seven males and eight females; median age 68 years (range 49e84). Changes in taste and food preference were common. None had received either radiation or chemotherapy recently. Ten reported subjective taste changes in response to direct questions. Most had weight loss and anorexia, which suggested a possible role of taste changes in the cancer anorexia-cachexia syndrome. Meat aversion was found mostly in females. Median energy intake for all was 1,475 kcal/d (range: 224e2,137). Amongst those with subjective taste changes most also had objective changes on formal testing. Subjective and objective taste changes correlated well. Hypogeusia for sweet and salt, and dysgeusia for sour were common specific taste changes. Conclusion. Subjective and objective taste changes in advanced cancer were common. Hypogeusia for sweet and salt, and dysgeusia for sour were predominant. Implications for research, policy, or practice. Awareness of individual food preferences helps plan diets with pleasurable meals, overcome anorexia, maintain adequate nutrition, and increase QOL.