Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

February 2015 Independent Eating and Drinking Newsletter

Independent Eating...   is a Wonderful Thing

February Topics:

  • Feeding Someone

  • How Do You Like to Eat?

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Feeding Someone

Once in a while a member of your family may become ill or injured, and as a result, be unable to feed themselves. This may be a temporary or permanent condition. Regardless, they will need someone to help them eat, or to totally feed them. There is a significant misconception among most people that if they have fed their children, they have experience in feeding people and that, therefore, they can feed an adult; they then tend to undertake the task in the same manner. However, feeding an infant is very different from feeding an older child or an adult as will be discussed in this article.

This Newsletter will provide insights and tips into making mealtimes easier, more enjoyable, and safer, for both the person eating and the person feeding them. Feeding another person is a task that should be viewed as constantly putting the person being fed at risk of harm. The primary risks associated with being fed are choking and/or aspirating. Both food and liquid can cause these conditions. More information is available about the risks of choking and aspiration in the Mealtime Partners October 2010 Newsletter.

There are some basic issues relating to feeding someone that typically evolve rather than being decided through discussion or logical observation. Things like where the meal will take place; where both people will sit; will they both eat at the same time, etc. Many families continue to eat wherever they ate prior to the family member’s loss of independent eating. In many cases this is alright, but it may make the feeding activity more difficult. For example, if both people sit in the location at the table that was previously normal for them, the feeding partner may not be able to present the utensil to the person at an appropriate angle. This can be corrected by simply sitting at the other side of the person; or if the table has straight sides, having one person sit on one side of the table and the feeding partner sit on the side that is perpendicular to the person eating. The choice of which side of the corner of the table the feeding partner should be located, depends upon whether they are right handed or left handed.

Positioning should allow food to be put into the mouth in a way that will encourage safe and comfortable eating. Check how the utensil is entering the person’s mouth; their head should be facing forward, with the tip of their chin slightly lower than their jaw line. (To verify that their chin is low enough, put a ruler under their ear at a right angle to the spine. The ruler should cover the jaw and the chin should be below the bottom of the ruler.) The head should not be significantly turned to the left or right. Often when someone is being fed, they turn towards where the utensil is being presented to accommodate the position of the person feeding them. This should be avoided. The head should always be forward. If presenting the utensil at a right angle to the person’s mouth is difficult for the feeding partner due to the positioning of both of the people involved, their chairs should be rotated towards each other so that the correct angle can be obtained.

Should the feeding partner sit or stand? In most instances it is most appropriate for the feeding partner to sit during meals because their arm and hand will be at a height to access the mouth of the person they are feeding most appropriately. However, for individuals who sit in one of the larger powered wheelchair while they eat, if the feeding partner sits on a standard chair, they may be too low to present the utensil at an appropriate level. If a tall stool is available, it may correct their positioning. However, sitting on a stool can make the feeding partner unstable because they do not have their feet on the ground. If this is the case, the feeding partner may choose to stand during the meal. In general, when standing to undertake a task, our reactions are different than when we sit. Care should be taken not to offer each bite of food too quickly after the previous one; this is a common inclination when standing to feed the care recipient.

Deciding the order in which to offer food is also a conundrum. Each of us has our own preferences as to how we eat a meal. For some people being fed can be unpleasant if they are offered bites of food in a manner that is different from how they would do it for themselves. Imagine the dinner plate as a clock. Meat is at 1 o’clock, potatoes at 6, and green beans at 9. The question is: do you go around and around the plate offering a single bite of each food until everything is eaten? Or, do you offer two bites of each food, around and around? Do you offer all of one selection until it is finished and then move on to the next food? Should you take a small portion of two or three items onto each spoonful? The options are endless, but to satisfy the individual likes or dislikes of someone when feeding them requires some preplanning. If the individual is able to talk and is cognitively in a position to communicate, this is quite easy. Simply discuss how the person would like to be fed. For someone who has limited speech, phrase the discussion in the form of questions that can be answered with a nod or shake of the head. This will give the feeding partner basic insight into how to offer food. However, a question or two during the meal can also make the person being fed more comfortable with how their meal is being presented.

One of the major complaints about being fed is that the feeding partner offers bites of food too quickly. When feeding an infant, most babies want bites of food one after another quite quickly, particularly at the beginning of the meal. It should be remembered that infants are eating soft food that does not require any preparation in the mouth (chewing) and, therefore, can be swallowed rapidly. For an adult, or older child, most of the food that they are being offered requires chewing and mixing with saliva prior to it being swallowed. Additionally, most of us like a pause in between bites of food. A good rule for the feeding partner to follow is for them to put the utensil down on the plate after they have given a bite of food. It is tempting to pick it up again and get the next bite ready. However, if you do this, the person eating tends to hurry up and swallow what they are eating to be ready for the next bite. To avoid being tempted to do this, once you have put the utensil down, put your hands in your pockets (or somewhere equivalent). Only take them out when you see that the person you are feeding has stopped chewing and swallowing. At that time, pick the utensil back up and prepare the next bite. This allows some breathing time between bites. The tendency to hurry is more easily avoided if the feeding partner is eating their meal at the same time.

How should spillage be handled? For many people who must be fed, not only have they lost their ability to use their hands and arms well, but they also have reduced oral motor control. This can cause food to spill from the mouth, drooling, or difficulty retaining liquid in their mouth as they take a drink. This is not just messy but also it is extremely embarrassing and humiliating for the individual experiencing these difficulties. A feeding partner should never use the spoon to clean food from around the mouth or off of the chin. Doing this repeatedly can damage the skin tissue in this area. Also, it is distasteful to most adults especially if the food is then put in their mouth! To clean food off of the face, use a paper towel. (Viva is a good brand of paper towel for this use because it is very soft). With a small piece of paper towel, gently remove the food and throw it away. This keeps the person and the dining area clean. (Paper towels are preferred over cloths because they are disposable and don’t require frequent trips to the sink for cleaning. Keep a trash container close during meals so the paper towels can be thrown away after use.) Do not wipe the face firmly. This can break down the skin tissue. Light dabbing is all that needs to be done during the meal. At the end of the meal the skin around the mouth can be washed with a warm soft cloth. Always dry the skin blotting it with a soft towel rather than a wiping action.

There are many aspects relating to being fed or feeding someone that can create an atmosphere that is enjoyable. Many of these aspects can be identified by talking about them and deciding upon methods that will best meet both people’s needs. As mentioned earlier, for many feeding partners, to eat at the same time they are feeding someone slows the pace of the meal and allows both people time to relax and enjoy the time and food.

Assistive Dining at its Very Best

The Mealtime Partner Dining System provides the means to eat independently for those who are unable to feed themselves in the traditional way. Because of its flexible design it can be configured to meet the needs of almost any user and will allow a relaxed, enjoyable meal that is under the control of the person eating. They are free to take a bite of food when they want, and to pause between bites for as long as they choose. Thus they are empowered to have a traditional mealtime and will never be hurried.

Because the Mealtime Partner has three different mounting systems, as well as it being placed directly on a table for use, it can be positioned to meet the need of a diverse range of users. The Support Arm allows the spoon to be positioned to deliver food very close to the user’s lips. A small forward movement of the head can access the food on the spoon to be eaten. The Support Arm is suitable for individuals who have very limited head movement because it can be fine tuned to the necessary position to provide access for them.

The Mounting Shafts provide comfortable positioning of the Mealtime Partner for those who sit close to a table but are unable to put their knees under the table because they are restricted by their wheelchair or for any other reason. The Shafts allow the device to pivot away from the table to allow easy access for users. Shafts come in five different heights.
The Mealtime Partner

The Mealtime Partner Assistive Dining Device Mounted on the Support Arm

The Mealtime Partner

The Mealtime Partner Mounted on a 6-Inch Shaft

For those users who are able to sit at a table with their knees under it to eat, the Mealtime Partner can be mounted on legs. The legs position the device at the appropriate height for each user. Legs are supplied in three different heights.

For additional information, please call us at
800-996-8607, or email our staff for assistance by clicking here.
The Mealtime Partner
The Mealtime Partner Mounted on 6-Inch Legs
The Mealtime Partner Assistive Dining Device is only available from Mealtime Partners, Inc., or Select Dealers.

How do You Like to Eat?

If you sit down to eat with family members or friends, it is unlikely that you will be able to describe how any of the people at the table ate their meal once everyone has finished eating. The same can be said for couples who have lived and eaten together for years and years. Because we are unlikely to observe, and remember very much about how someone eats during meals, we are inept at supporting them in an enjoyable manner should they need help eating. We, of course, are happy to be of assistance. However, when we take on the task of feeding another person, we typically decide how food should be offered rather than presenting it in the manner the person being fed would eat it if they were feeding themselves.

This creates a basic problem. The person being fed is normally very appreciative of the help they are being provided and does not wish to impose any additional burden upon the person who is feeding them. Therefore they do not comment about how food is being presented to them. The person doing the feeding thinks that because they are offering food in the way in which they like it, that the meal is progressing well and being enjoyed. In reality, if food is not presented to us in the way we like it, much of the meals enjoyment is removed. In some cases it can even become distasteful.

Consider an example: you are eating breakfast and it includes scrambled eggs, bacon and toast. Do you season your eggs? Do you use salt and pepper, or just salt? Do you like to add ketchup or Tabasco sauce? If you add any of these items, how much do you like, a little or a lot? Do you add more as the meal progresses? Do you like butter on your toast or do you like it dry. Do you want to put jelly on the toast? Do you pick the bacon up with your fingers and bite a piece off, or do you cut it up and eat it with a utensil? These questions relate to preparing food prior to it being eating. Offering a bite of food to someone in the manner they are used to, requires an entirely new set of questions. Do you eat a bite of eggs, a bite of toast and finally a bite of bacon or do you put a little of each item on your utensil and eat them together all at one time? Do you eat all of the eggs and then move on to eat all of the bacon and finally eat your toast, or do you eat a bite of each food selection one after another until they are all eaten?

As you can see by this example, there are many possibilities as to how food can be prepared and served. How food is eaten is an extremely personal selection, and to make it even more complicated, our choices can vary from day to day. With an understanding that everyone has very distinct preferences about what tastes good and how to make it pleasurable, how do you go about accommodating the needs and preferences of someone you are feeding?

Being aware that people like food served in different ways is a good start. If you understand that someone will most likely prefer eating differently from your own preferences, it will help you provide a more enjoyable mealtime experience for them. One gentleman who was fed by a caregiver complained that even when served poached eggs with a soft yoke, it was not served on toast with the yoke broken. It was served as a bite of eggs and a bite of buttered toast. There was no yoke on the toast. He really enjoyed egg yoke on his toast but was never served it in this manner. Even when he requested it, the eggs and toast were served this way for a single meal and then food presentation reverted back to the previous way. His caregiver simply did not understand how important meals are to people who are unable to feed themselves. If you cannot self-feed, you most likely are relatively dependent upon other people for all of your daily needs. Meals often become a significant break in the day and thus more important than they are to people who are able to be more active. Because mealtime becomes more important, the food and how it is prepared and presented is also more important.

Understanding that meals are a time that can bring great pleasure, care providers, despite their being very busy, should try and understand how to provide an enjoyable experience at most, if not all, meals.

Did You Know? Did you know that people who donate blood recover more quickly if they take an iron supplement? According to an article authored by scientists from the National Heart, Lung and Blood Institute that was published in the February 10, 2015 issue of The Journal of the American Medical Association (JAMA), participants who received daily iron supplements for 24 weeks after they had donated blood, regained 80 percent of the iron lost during the donation within 5 weeks. Study participants who did not receive iron supplements took 11 to 23 weeks to recover.

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