Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

August 2011 Independent Eating and Drinking Newsletter

Independent Eating...   is a Wonderful Thing

August Topics:

  • Hydration for Hospital Patients
  • The Changing Face of Eating due to Degenerative Diseases
Mealtime Partners Home Page
Send a Comment or Suggestion

Hydration for Hospital Patients

Most of us have ended up in the hospital at least once in our lives. Many hospital stays are scheduled and are to treat minor problems. With the current standards set by insurance companies for payment, many hospital visits are for day surgery and the patient is in and out of the hospital in just a few hours. However, for those visits that are an emergency and/or to treat very serious difficulties, everything is different. First, patients may start out in the Emergency Room and later be moved to another section of the hospital depending upon the type of treatment they are to receive and the level of care necessary. This might include being in Intensive Care, Cardiac Care, or a Surgical Unit. Many of these patients do not initially take food or liquid by mouth, instead they receive all hydration and nutrition intravenously, but over time they resume, first drinking by mouth, and then eating by mouth. For many, reaching for a cup and lifting it to their mouth, even if a straw is available, is a very demanding task, if not impossible. Consequently, they are dependent upon other people to help them. Frequently, the result is that they do not consume enough fluid.

Consuming an adequate amount of water is a critical component of recovery from either surgery, illness or an accident. Dehydration significantly impacts the body’s ability to heal. Without an adequate intake of water, patients heal more slowly and/or develop secondary complications. However, in many cases attaching equipment such as drinking systems or Sip N Puff control systems (etc.) to the intelligent beds used in these high-care units has proven unsatisfactory. Because the bed rails for many of the new beds are made of molded plastic to accommodate the electronics that make the beds so capable, clamping equipment to the rails has presented a problem. Using commonly available clamps, the plastic bed rail begins to compress due to the clamping pressure and the clamp does not maintain its position over time. Thus the equipment shifts its position and soon becomes unavailable to the user. Mealtime Partners now offers a Hospital Bed Clamp System that solves this problem. It uses both the top and bottom bed rails to distribute the clamping pressure over a much larger area and, thus, will hold its positioning indefinitely. An Attachment Holder is fastened to the clamp body and permits various shaft sizes to be held securely. Thus attaching a drinking, or other type of system is now easily accomplished.

The Attachment Holder fastens to the side of the Clamp and can firmly hold a Flex Arm that comes with several products or a Drink Tube Positioning Conduit that comes with the Mealtime Partners Hospital Bed Hydration System. The Attachment Holder is held on the clamp body with two screws and can be rotated 90 degrees, so the device it is holding can emerge in either direction. Also, the clamp can be mounted with the Attachment Holder on the inside or outside of the bed rails. (Two tools are provided to easily accomplish these changes.) A thumb screw is used to hold the Flex Arm or Drink Tube Conduit (or other similar size device) in place so they can be quickly removed for cleaning or patient care without tools.

Hospital Bed Clamp
Hospital Bed Clamp with Attachment Holder

Using the 2-piece bed rail clamp and Attachment Holder described above, Mealtime Partners now offers two new products: a Hospital Bed Clamp System and a Hospital Bed Hydration System.

The Mealtime Partners Hospital Bed Clamp System provides a method of mounting flexible arms (commonly used to mount Sip N Puff Controls) firmly to a hospital bed rail. For patient’s who are unable to use their hands and arms to use their hospital bed controls, a Sip N Puff control may be provided so that they can call the nurse, turn the television on or off, change television channels, etc. Because of the yielding nature of the bed rails, the Sip N Puff is likely to move if clamped with a traditional single point clamp. Therefore, the most vulnerable patients may not be able to call for help because the Sip N Puff control has slipped out of position. The Mealtime Partners Hospital Bed Clamp is designed to hold its position indefinitely.

The Hospital Bed Clamp System can also accommodate a drinking system when a Sip N Puff Flex Arm is installed in the clamp. The Hospital Bed Clamp System is supplied with not only the Clamp and Attachment Holder (and tools to install and adjust the clamp) but a Drinking Tube Guide and Velcro strips. If a drinking system in needed in unison with a Sip N Puff, a Hydration Backpack Unbottle (Mealtime Partners Part No. 6556) can be purchased and added to the Clamp System. To install the drinking capability to the Sip N Puff Flex Arm, the drink valve at the end of the drinking tube should be removed and the drink tube slotted through the Drink Tube Guide. The valve should then be replaced in the end of the drinking tube. The clips on the side of the Drink Tube Guide should be snapped around the Sip N Puff Flex Arm near the mouth of the user. This will position the Sip N Puff mouth control and the drink valve side by side with a small gap between them thus allowing a patient to move their mouth from one to the other without them interfering with each other. The drinking tube from the Hydration Backpack Unbottle can be attached to the Flex Arm with the Velcro strips making both the control system and hydration available at the same time. The Drink Tube Guide provided with the Mealtime Partners Bed Clamp, holds the drink tube and the Sip N Puff tube around ½” apart. The picture below shows what this dual purpose system looks like when installed on a hospital bed.

Mealtime Partners Hospital Bed Clamp System
The Mealtime Partners Hospital Bed Clamp System with Sip N Puff and Drinking Tube

 The Mealtime Partners Hospital Bed Hydration System provides a stand-alone hydration system for the intelligent hospital beds described above. The system provides drinking tube positioning using a tube positioning conduit, to hold the drink valve close to the patient’s mouth for easy access. Everything that is needed to add drinking to an intelligent bed is included with this system. The bladder that comes with this system holds 100 ounces of liquid. Therefore it does not have to be refilled as frequently as a cup, saving hospital staff time. This hydration system makes a drink readily available to patients through the day and night.


Hospital Bed Hydration System
The Mealtime Partners Hospital Bed Hydration System

For information about all of the Mealtime Partners Drinking Systems, click here, or call 800.996.8607.

Did You Know? Did you know that sausage was the first processed food? It was mentioned by Homer in the Odyssey. The Roman word for sausage was botulus (the origin of the word Botulism). Hot dogs are responsible for causing 17 percent of food-related asphyxiations in children under 10. If you are feeding children hot dogs, cut them up into uneven shapes that will not block the windpipe if a child were to choke on a piece. (Source: Discover, Science Technology, and The Future; September 2011.)

The Changing Face of Eating due to Degenerative Diseases

Some diseases impact our ability to eat independently. In some cases this is temporary; in other cases it is a progressive problem. The cause of the difficulty significantly impacts how the impediment will be manifested. Arthritis may limit an individual’s ability to hold a utensil or lift their hand to their mouth, but amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, can impact not only the individual’s ability to handle a utensil or lift their hand, but in many cases can impact their capacity to chew and swallow.

This article will briefly address some of the issues relating to eating and drinking when someone has a degenerative condition. It is wiser to anticipate problems and identify a solution for them prior to their occurrence. It should be noted that the impact of some diseases is to cause weight changes in individuals. In some cases people will loose weight even if they are consuming the same number of calories that they have always eaten. This is generally caused by a reduction in muscle mass. Other people will gain some weight and sometimes this can be attributed to them reducing their activity level.

First, we will discuss chewing and swallowing difficulties because, if not adequately addressed, they can cause choking, aspiration, aspiration pneumonia and even death. If someone is diagnosed with a disease that impacts the muscles and causes any kind of muscle wasting, it is common for the muscles of the throat, neck and mouth to be impacted. If this occurs, all the functions of eating and drinking are affected; this includes chewing and swallowing, and also impacts saliva and mucous control.

Because eating and drinking are complex activities involving interplay between the digestive system and the respiratory system there is always a risk of choking, even if it is on saliva rather than food or a drink. For more information about the mechanics of why we choke please refer to the Mealtime Partners October 2010 Newsletter Topic: Why We Choke which discusses this issue. Generally speaking, our muscles automatically do everything necessary for us to chew and swallow safely; however, if the muscles that coordinate this process become weakened, they do not work as efficiently. To prevent food or liquid from “going down the wrong way” the soft palette at the back of our mouth must close the passage that connects the nose to the mouth. Also, the muscles in the throat must close the airway to the lungs when swallowing occurs. Without these two things happening we will choke.

Coughing is a sign that someone has inhaled foreign matter (food, liquid, saliva, mucous) into his or her windpipe. Even if only tiny particles are inhaled, a cough will commonly occur. When a very tiny amount of material is inhaled it is called micro aspiration and the esophagus frequently becomes sore if this occurs.

To reduce the risk of choking and aspiration it is recommended that the individual eating or drinking sit in an upright position. Even if they are in bed, pillows should be placed behind their back to put them in a good position for swallowing. Once the person is upright their head should be tilted forward so that their chin is lowered to near their chest (refer to the June 2009 Newsletter for more details about Promoting a Chin Tuck for Safer Eating). Should anyone continue to experience choking or excessive coughing when in this position to eat or drink, they should seek medical advice on the best practices for them to eat and drink safely. They may be referred to a speech pathologist for a feeding assessment.

When eating and drinking difficulties are experienced it is important to address how to intake enough nutrition and fluids while reducing the risk of choking and without exerting too much effort to eat and drink. Becoming fatigued during a meal produces a higher risk of choking and should be avoided.(The Mealtime Partners February 2010 Newsletter topic: Avoiding Mealtime Fatigue provides additional details on this subject.)

The texture of the food being eaten is important. (The April 2010 Newsletter provides more details about Food Texture.) The easiest texture to consume without difficulty is semi-solid food (the consistency of thick oatmeal). Foods that present the greatest difficulty are those with a mixed texture like soup that has both thin liquid and chunks of meat and/or vegetables; food that is stringy like celery; gummy food like white bread that can stick to the roof of the mouth; hard foods like nuts; and crumbly food like cookies. The oatmeal consistency that is easiest to chew and swallow does not necessarily need to be produced by blending food; sometimes simply cooking food a little longer can soften it enough for it to be smashed with a fork. However, if lumps of any kind in food presents difficulties, mincing or blending the food is advisable.

Many diseases do not change a person’s sense of taste and so it is important to provide flavorful foods, rather than bland food, so that the individual will continue to be motivated to eat their meals (see our January 2010 Newsletter for more information about the importance of Food Flavor). Excellent nutrition should be the goal for all meals, but good tasting food provides additional incentive to consume the required calories.

Everyone should drink at least 1.5 to 2 liters of liquid a day. When trouble is experienced with drinking, several strategies can be employed to reduce the difficulties. The most important thing to remember is not to reduce the quantity of liquid being consumed despite the difficulties of being able to coordinate taking liquid into the mouth and swallowing it without choking or aspirating. (See our November 2009 Newsletter for more information about The Importance of Hydration). Reducing intake of fluids will result in two significant problems to chewing and swallowing. First, mucous secretions produced by the body will become thicker. This, in turn, will make clearing them from the throat, sinuses, mouth, and nose more difficult. Secondly, the likelihood of constipation is increased with the reduction of fluid consumption. Constipation tends to make people feel that they are not hungry and, therefore, they do not want to eat. Even when it is difficult, adequate fluid consumption is essential.

It is recommended that sips of liquid (a teaspoonful, or less) are drunk ongoingly rather than one bigger drink every hour. This has a two-fold benefit. Sipping liquid is an easier way to drink while reducing the risk of choking, as well as an easy way of consuming a significant amount of liquid without having to really concentrate on drinking. If a larger drink is taken, the individual must think about all of the steps that they should take to safely swallow the quantity of liquid.

If someone does choke, do not slap them on the back when they are coughing because it tends to make them inhale, which worsens the risk of aspirating whatever is being choked on. Instead, have them try to relax and rest their elbows on the edge of a table while leaning forward and breathing slowly. If you choke frequently, discuss this with your physician. Ask for recommendations for strategies to reduce the occurrences and advice for both you and your caregiver about how to handle choking episodes when and if they occur. Your physician may recommend that liquids and/or thin foods be thickened. For more information about available thickening products refer to the February 2010 Newsletter article titled Thickening Food and Liquid)

Hopefully, even with a degenerative disease, mealtime can continue to be an enjoyable time with family and friends. However, when eating with other people do not hurry your meal, even if those around you are finished. Take your time and eat at the pace that is appropriate for you to eat safely. If you are uncomfortable continuing to eat after others have finished, leave part of your meal uneaten. Either eat it later, or have a snack later. Never try to keep up with the eating pace that those around you maintain.

Below are links to websites with sources of information on this topic:

Arthritis Foundation –

Amyotrophic lateral sclerosis (ALS) Association -

The Multiple Sclerosis Association of America (MSAA) –

Parkinson’s Disease Foundation (PDF) –

The Muscular Dystrophy Association (MDA) –

(MDA have programs for: Various Muscular Dystrophies; Motor Neuron Diseases including ALS & Spinal Muscular Atrophy)

Spinal Muscular Atrophy Foundation –

American Speech Language Hearing Association (ASHA) –

American Occupational Therapy Association (AOTA) –


           It’s Back to School Time

For many students setting meaningful goals needs to includes assistive technology (AT). Individual Education Plans (IEP) should include the AT that can help a student reach important goals. For those students who are working on reaching functional goals for independent eating, the Mealtime Partner Assistive Dining System can be included in the IEP. To be able to feed yourself is a huge step towards gaining independence and a very worthwhile and significant goal!

The Mealtime Partner Dining System easily serves most table foods and has very reliable food pickup. It is the only device of its kind that accommodates small children. It is portable and easy to setup and use in both school and home environments and will provide reliable operation for many years as they grow.

For additional information, please call us at 800-996-8607, or email our staff for assistance by clicking here.

Child Using the Mealtime Partner

The Mealtime Partner Assistive Dining Device Positioned on a Table

A four year-old can easily use a Mealtime Partner Dining System to learn to eat independently. For more information about this dining system, click here.

The Mealtime Partner Assistive Dining Device is only available from Mealtime Partners, Inc. or Select Dealers.

August 2011 Newsletter References:

This month's references are embedded within the text, above.

Mealtime Partners Website Navigation:

Home | Dining | Drinking | Videos | Products | Warranty | Ordering | Calendar | FAQ | Newsletters | Contact


Please send comments and suggestions to

Copyright © Mealtime Partners, Inc. 2011

All rights reserved.