Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

January 2013 Independent Eating and Drinking Newsletter

Independent Eating...   is a Wonderful Thing

January Topics:

  • The Effect of Cold Weather on Skin

  • Seating and Positioning After Eating

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The Effect of Cold Weather on Skin

Almost everywhere in the United States is experiencing some level of cold weather, even though for many it is much colder than those living in the southern states ever experience. Cold air contains much less moisture than warm air. Therefore, the heated air indoors has very low relative humidity. The result of dry air is dry skin. Skin dries out in stages. First it is dry and itchy, and then it becomes flaky; if not treated, it will start to break down and will crack. Once this has occurred, cracked skin, especially around the finger nails, is difficult to heal.

This is a problem for everyone, but for those who spend their waking hours sitting in a wheelchair, the difficulty of dry skin can become a significant problem for their buttocks as it can be the precursor to pressure ulcers. The skin on the buttocks can begin to break down if it is allowed to become very dry. Therefore it is advisable to take preemptive measures to avoid tissue breakdown from dry skin. Also, for those who use manual wheelchairs, the skin on their hands and around the fingers can become dried and cracked from cold temperature, dry air, and the skin contact involved in propelling their wheelchair. For these individuals, the choice of gloves is important, The gloves should insulate their hands from moisture as well as the cold.

Prevention of skin breakdown is the optimal solution but is difficult to achieve. Some tips on helping skin survive the winter are as follows:

First and foremost, drink lots of water. Without an adequate amount of water inside the body, skin can easily dry out in any weather. Therefore, one line of defense against dry skin is a steady consumption of water. Around 100 ounces of water a day will keep most people thoroughly hydrated. If tracking the amount of water that is consumed throughout the day is inconvenient, another way of knowing that plenty of water is being consumed is the color and volume of the urine being excreted. It should be clear and pale yellow, and more than a cup should be excreted at one time. This level of water consumption will not only help skin through the winter but will also reduce the risk of urinary tract infections. Dehydration can exacerbate the discomforts of winter by making the body feel constantly cold, or for some people, feel extremely hot. Both of these feelings should be addressed as soon as anyone experiences them.

Water alone is not enough to protect the skin from winter’s assault. Body lotion should be used regularly. Craig Hospital’s Cat Davis, RN (Vogal, B. “Winterizing an SCI Body”, New Mobility, January 2013) recommends avoiding lotions that have alcohol or perfume in them because they can irritate the skin. Use lotion on any parts of the body that are often dry. Do not wait until the skin is flaky. In the winter, for those who sit in a wheelchair all day, it is wise to lotion the buttocks before getting into the wheelchair, and again when going to bed.

Showers and baths can significantly contribute to drying the natural oils out of skin. They should be as short as possible and extremely hot water should be avoided. Also, many varieties of soap are harsh and contribute to drying the skin. Mild moisturizing soaps, or bath gels, are a wiser choice for winter bathing.

Regardless of good skin care it is easy for winter weather to cause drying and skin should be checked regularly to make sure that there is no degradation. This is especially important for those who have little or no sensation in their lower body. It only takes a short time for skin to start breaking down and prevention is a much easier way of dealing with skin problems than treatment after they have occurred.

For those who are unable to drink independently, it is advisable to have a hands-free drinking system in place at all times. That will allow them to maintain proper hydration without aid from another person. This is a way of keeping the skin hydrated from the inside out. For information about the Mealtime Partners drinking products, including a variety of hands-free drinking systems, click here.


Hands-Free Drinking
For most individuals, dehydration is 100% preventable. However, many people with disabilities suffer from some level of dehydration almost constantly. Mealtime Partners various drinking systems allow many individuals who are unable to use their hands to take a drink, to drink independently. For example, the Hydration Backpack Drinking System with Drinking Tube Positioning provides hands free drinking throughout the day for those who sit in a wheelchair and are unable to lift or hold a cup or glass. The drinking system is quick and easy to set up, the liquid container fits on the back of a wheelchair and the drinking tube can be positioned to meet the unique positioning needs of each individual.

The Front Mounted Drinking System can position a variety of cups and drink containers very close to the users mouth for hands free drinking and permits a variety of drinks to be made available throughout the day. For example, coffee in the morning, ice tea with lunch, a can of soda in the afternoon and a glass of milk before bed. The user drinks from their own container using a disposable straw. Because the straws and most of the containers can be disposed of or washed in a dishwasher, it is the easiest drinking system to clean.
Hydration Backpack with Drinking Tube Positioning Front Mounted Drinking System
The Hydration Backpack with Drink-Tube Positioning The Front Mounted Drinking System

Making liquid constantly available allows the user to drink whenever they want. This lowers the risk of dehydration and improves the quality of life for those who have one of these systems. Click the following links for pricing and/or for ordering the Hydration Backpack Drinking System with Drinking Tube Positioning or the Front Mounted Drinking System.


Seating and Positioning After Eating

A regular commentary in the Mealtime Partners Newsletter is that appropriate seating and positioning are essential for safe eating and digestion. It has been specifically addressed in several newsletters including July 2009 Newsletter, March 2010 Newsletter, and June 2011 Newsletter. However, only cursory mention has been given to seating and positioning once you have finished eating. This article will address recommended after-meal positioning and why it is significant.

The digestive process can be broken down into four stages: ingestion, digestion, absorption/assimilation, and elimination/defecation. The process starts with ingestion (when food is placed into the mouth). Depending upon the specific food and its texture, the teeth will grind it into particles and mix it with saliva, which not only moistens the food but starts the digestive process. The food is chewed and moved around the mouth until it forms into a ball, or bolus. The bolus is moved to the back of the mouth by the tongue elevating and pushing it backward in the mouth. Once at the back of the mouth, it is propelled into the esophagus. The muscles of the esophagus move the food downward into the stomach (digestion). When the food has been eaten and is in the stomach, digestion is begun. Acid and various other chemicals are mixed with the food and it is gradually changed into a thick liquid. Different foods digest at different rates in the stomach; for example, soup will digest more quickly than steak. The stomach has two valves, or sphincters: one at the top of the stomach, the esophageal sphincter; and another at the end, or bottom, of the stomach, the pyloric sphincter.

Illustration of Stomach and Esophagus

Problems like indigestion and gastroesophageal reflux (GERD) occur while food is in the stomach being digested. Many people have no problems digesting food and will often boast that they have a “cast iron stomach” meaning that they can eat anything (spicy, fatty, or heavy foods) without experiencing digestive problems. Many other people, including infants, have troubles with reflux. Reflux occurs when the contents of the stomach leaks upward through the esophageal sphincter into the esophagus. The matter that is returned to the esophagus is acidic due to the stomach acid that digests the food. The lining of the esophagus can be damaged if reflux occurs constantly, and, therefore, it is important to treat the problem. More information about GERD can be found in our April 2012 Newsletter.

For those who experience problems with indigestion, reflux, or slow digestion (delayed gastric emptying), their position and activities after a meal are important. One thing that many people describe after eating is that they become sleepy. Some even take a nap after a meal. However, if you frequently have indigestion or acid reflux, it is unwise to lie down to nap immediately after eating. Sitting in a recliner and dozing is fine but the goal should be to keep your body upright. The illustration of the stomach in the figure above shows that the flow from the mouth to the intestines is a downward flow, and thus gravity participates in the digestive process. If you lie down, gravity can no longer encourage the movement of food downward. Also, the esophageal sphincter may not close tightly, and if you lie down, food and stomach acid can leak back through it into the esophagus. This is less likely to occur if you remain in an upright position.

Sitting for a while after a meal allows your body to prioritize digesting the meal. If you become active immediately after eating, your body will give precedence to the most strenuous activity that is going on and will direct less energy to digestion. The length of time that you sit after a meal depends greatly upon what has been consumed and how the individual’s normal digestive process works. It should be remembered that consumption of plenty of water during and after a meal aids the body’s ability to process a meal and allows it to pass into the intestines which absorb nutrients from what has been eaten (absorption). A secondary benefit from water is that it lessens the risk of constipation and allows the waste from the meal to be passed from the body (elimination/defecation).

Did You Know? Did you know that an estimated 12,000 people in the U.S. receive a spinal cord injury (SCI) each year and survive the initial accident? That is about 40 cases per million of the population in the US. The majority of those injured are males, and the average age at injury is 41 years. A significant increase in age has occurred over the past 30 to 40 years. 39.2% of spinal cord injuries are due to motor vehicle crashes. The next most common cause is falls, followed by acts of violence which are most commonly gun-shot wounds. Depending upon the severity of the injury, life expectancy for someone with a SCI, if they survive the first year after injury, is somewhat less than those without an SCI. More information on this topic can be found at

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