Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

June 2011 Independent Eating and Drinking Newsletter

Independent Eating...   is a Wonderful Thing

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 Positioning for Eating Revisited

An article in our July 2009 Newsletter discussed “Positioning for Eating’, and because this is such an important subject to many of our customers, we are going to revisit the subject and try to recap the key elements of good positioning for eating.

The entire body needs to be considered when positioning is evaluated. Without all parts of the body working together it is difficult to create a stable position that will facilitate safe and comfortable eating. Many people believe that the mouth is the most significant part of the body when it comes to eating. Even though this might be true because food and liquid enter the body through the mouth, without the rest of the body to support its activity, the mouth and its associated parts (e.g., tongue, jaw, etc.) have a hard time performing well.

Working from the ground up, here are the essentials of stable positioning. The feet must have a firm surface to rest on and push against. Without firm footing the whole body is unsteady. (Think of how it feels when you sit on the edge of a counter with your feet dangling down. You tend to put your hands on the counter to steady yourself and create a safer feel.) Once the feet are supported appropriately, the rest of the body can be aligned. The thighs need to bear the weight of the torso. To accomplish this, the trunk should be positioned over the hips enough to generate weight on the thighs. When this position is achieved the body has a feeling of alertness rather than when it is in a reclined position (that indicates to the brain that the body is at rest).

To create a comfortable seating position while in this weight bearing position, the back of the chair should be adjusted to provide support. If this is not possible, a small, firm cushion, folded towel, or wedge should be placed between the person’s back and the chair back. This allows the individual to lean back and be supported while they are maintaining weight on their thighs.

Once the trunk is supported from behind, side-to-side movement should be addressed. Many people do not have problems with lateral movement but support should be provided for those who lack the muscle tone to remain upright without slumping sideways during a meal. This can be accomplished by using a chair with arms. If the person slumps within the support of the arms of the chair, small pillows or folded bath towels can be positioned between the person and the arms to create a “snug” fit in the chair. That will lesson the likelihood of slumping, because it has provided greater support.

When the legs, seat and trunk are positioned as described above, it is time to address the arms. The majority of people do not need any special support for their arms. However, for those people who have limited control of their hands and arms, arm support is essential to provide shoulder and head stability. For those sitting in a wheelchair, a laptray can provide excellent support for the forearms; for those who sit at a table, the table surface can provide similar support. The upper arms and elbows should be an inch or two away from the side of the body. Any greater gap indicates that the surface being used is either too high or too low. Once the forearms are resting on a firm surface with the elbows close to the body, the position will naturally produce a slight forward and lowering of the shoulders. This, in turn, will produce a slight lowering of the chin. This position is, for most people, both safe and comfortable for eating.

For additional information on this topic please refer to the previous Newsletter topics: Positioning for Eating; Promoting a Chin Tuck for Safer Eating; Good Buttocks Positioning Promotes Safe Eating; and, Considerations for Helping People Eat.


Did You Know? Did you know that ConsumerLab tested 50 of the most popular multivitamins and found that one in three did not contain the amount of nutrients that the manufacturers claimed. Vitamins and minerals are not regulated by the Food and Drug Administration (FDA). The ConsumerLab recent findings and the lack of FDA oversight of this industry is especially troubling for those who are medically vulnerable or fragile (e.g., the chronically ill, elderly, and pregnant and nursing mothers). The findings revealed both excessive amounts of vitamins (which can be harmful) and too little in some of the most popular multi-vitamins. For more information about this report, click here.

Using the Mealtime Partner as a Teaching Tool

It is common for therapists, teachers, and family members to find it difficult to identify activities that are ongoingly interesting to individuals who have severe physical and/or intellectual disabilities. For many people, food can be used as a motivator and a reward system. Because of that, the Mealtime Partner Dining System can be used as a teaching tool while naturally creating its own reward for the user’s effort.

Several skills can be taught using the Mealtime Partner. Adaptive switch use is the first skill that is normally taught. Many children might have used adaptive switches but are not necessarily proficient users. To use the Mealtime Partner to teach switch use, the device is set up with two adaptive switches plugged into it. A food that the person being taught really likes is placed in one of the bowls. The bowl with the food is rotated to be under the spoon. At this point only the switch that activates the spoon will be employed. Hide the second switch from the user’s view but keep it plugged in (because the device operates differently if it has a single switch plugged in than it does with two switches plugged in). The user will receive a bite of food for each switch-activation that they complete, thus learning switch operation and cause and effect. They depress the switch and they get a bite of food. Practice is essential for proficient switch operation. If a person only eats a snack each day using the Mealtime Partner, in the period of just a month, they will have pressed the switch more than 100 times. This is a significant number of switch activations and their skills at switch operation will be perfected in a relatively short time.

Once the user has become proficient at using a single switch, a second switch can be introduced. As with introducing the first switch to the user, the most suitable switch should be selected for the user, and its location identified. The second switch will allow the user to learn how to make choices for themselves. When the second switch is first presented to the user, all the bowls are filled with the same food. The user can press the switch that moves the bowl and then the switch that will serve a bite of food. Regardless of which bowl they select, they will receive a bite of food that they like. When they have experienced this option for several snacks, place the food in only two bowls. Now the user must move the bowls to those containing food to get a bite. If they select the empty bowl they will not receive a bite of food. Gradually, they will acquire the understanding and skill to move past the empty bowl and only select the bowls with foods in them. Once they demonstrate that they have mastered this skill, place a preference food in one bowl, a food that the user does not like in the second bowl, and leave the third bowl empty. If the user has understood the previous lesson, they will skip the food that they don’t like and the empty bowl, and only eat from the bowl with the preferred food in it. They might taste the food that they don’t like the first time they pick up a spoonful but they will skip it on subsequent bowl rotations if they understand how to operate the second switch effectively. When this mastery is demonstrated, the user understands how to make choices for themselves.

An additional benefit for someone who has never been able to undertake independent eating is that they will begin to understand self-regulation. Over time, and with practice, they will learn how to pace their eating to suit their own needs rather than having someone else make the decision as to when each bite of food is put into their mouth. Typically a user will eat quite quickly at first, because when they have been fed, that is the pace to which they have become accustomed. Once they understand that they are free to eat at the speed they want, most individuals eat more slowly.

This is just an overview of some of the skills that can be acquired by using the Mealtime Partner Dining System: adaptive switch operation; cause and effect; choice making; and self-regulation. Even though it is an excellent teaching tool, more importantly, it provides the pleasure of independent eating. And. the Mealtime Partner can be used for many students within one classroom when it is used as a teaching tool rather than just an eating aid for meals. For more information about the Mealtime Partner Dining System, click here.


New Front Mounted Drinking System

Mealtime Partners Inc. has now added a 30-inch heavy-duty "gooseneck" flexible arm to its line of Front Mounted Drinking Systems. This additional length will allow access to a drink for small children who need the cup holder to be close to their mouth, or the elderly who have a limited range of motion, and thus need the flexibility provided by a longer gooseneck.

Now that summer is here, remember not to forget about adequate hydration. For those who get out and about in a wheelchair and cannot use their arms or hands to access a drink, there are several hands free drinking systems that can be attached to wheelchairs. With a drinking system on a wheelchair, the person using it can maintain their hydration level independently.  No more need to be thirsty or constantly asking for a drink.

Mealtime Partners, Inc. has a variety of different drinking system to provide independent drinking to those who cannot use their arms or hands to take a drink. To see the complete selection of Mealtime Partners Drinking Systems, click here.

If you're not sure which system to choose? Call 1-800-996-8607, or email our staff for assistance by clicking here.

Front Mounted Drinking System

The Front Mounted Drinking System Mounted on a Wheelchair

Remember dehydration can occur quickly during hot weather so make sure access to water is readily available for those who cannot help themselves to a drink.

For more information about the problems resulting from dehydration, click here.

The Front Mounted Drinking System is only available from Mealtime Partners, Inc.

June 2011 Newsletter References:

Links to the June 2011 references are all embedded within the text.

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