The aim of this study was to clarify diet and meal preparation for terminal cancer patients followed at home. A cross-sectional survey was administered to bereaved caregivers of 200 cancer patients who received home care from five palliative care clinics in Kobe in 2014. The response rate was 66% and the average age of the caregivers was 62 years. Overall, 57% of caregivers reported distress regarding diet and meal preparation for patients. The independent determinants of distress were: the experience of coaching from medical staff (P=0.012); how to help patients with eating; difficulties in cooking and meal preparation (P=0.001); and helping with eating for anorexic patients (P=0.004). Due to the paucity of the evidence about diet and meal preparation for cancer patients, caregivers may not be receiving sufficient specific and practical dietary instruction from medical staff.