Stage 4 dementia: Inability to eat and now on hospice: What to do?

When my mom was in the memory care facility and reached a level very close to what you are describing with your loved one, the staff looked at the refusal to eat, possibly inability to eat, was typically a sign that death was near. I can’t tell you how many times this happened and then lo and behold one day she would eat her breakfast! This pattern continued for a few months and then my mom did pass away. She was so far gone intellectually that it made no sense. The tube feed her or hook her up to IVs. It did make sense that this progression was something the train staff so regularly so that helped me feel less guilty about not doing something to make my mom eat. It was really really hard. Maybe it was just unique with my mom, but the staff at her facility insisted that it was a pattern that they often saw. HTH.

I did training to volunteer for our local hospice and we were educated about this stage, and told it was better not to force anyone to eat. Offering a mere taste of something for pleasure was okay if still possible.

Two years later my mother stopped eating for 3 months at age 95 (with vascular dementia, serious heart issues etc.) and didn't leave her bed, I offered ice cream and she would have, literally, half a bit. At first I gave her Sustacal but pretty quickly yielded to what was going on.
She lost 45 pounds.

My mother mysteriously resumed eating and getting out of bed for a month, then died peacefully at hospice after having chest pains.

They can live for awhile without food but without water life ends quickly. We did not do any IV hydration.

Have you talked to the hospice ppl? What do they say?