Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

October 2011 Independent Eating and Drinking Newsletter

Independent Eating...   is a Wonderful Thing

October Topics:

  • The Significance of Mealtimes
  • The Use of Prosthetics for Eating
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The Significance of Mealtimes

There are very few societies that do not commemorate special occasions with the cooking and sharing of food. Whether it is because of a happy occasion like a birthday or wedding, or a sad occasion like a funeral, the sharing of food is how people show one another that they care about what is happening.

There are meals that are very important and significant to almost everyone. For example, in the United States the meal served for Thanksgiving traditionally is planned and prepared with a great deal of attention. It is served with fanfare and in many cases shared by many family members and friends all joining together to enjoy the feast and fellowship of the special event. Yet on a day-to-day basis, meals are of no particular note. Some are very tasty, others not so enjoyable, many are hurried, and they fill our stomachs for another few hours. Two weeks later we won’t necessarily remember what we have eaten.

However, for those who reside in facilities like assisted living centers, or nursing homes, meals can be a very important part of each day as they are a break in the tedium of a daily routine and provide a little distraction. This is especially common for those who are limited in their ability to move around and participate in activities without assistance. Therefore, it is very important for those providing care to the residents of these facilities to remember what an important time mealtime is and help to make it an enjoyable part of the day.

That is easy to say, but not necessarily easy to do. In most nursing homes, mealtimes are the busiest times of the day. Those providing meals and assistance with eating are expected not only to serve food to each individual, but in many cases, assist residents with cutting up food, and feed several people as well. This type of workload can be stressful and, as a result, the care provider hurries to take care of all of their responsibilities in a timely fashion and may forget how important a smile and a kind word can be. The additional consequence that comes with this heavy workload is that when feeding clients, the care provider hurries the person being fed. This is not necessarily a conscious decision but a result of knowing what must be done within the mealtime period.

Being hurried (or at least the perception of it) can also result from the caregiver holding the utensil being used to provide food, in their hand between bites. The inclination is to refill the spoon or fork to be ready for the next bite, as soon as it is empty. This creates a perception on the part of the person being fed, that the next bite is ready and that they should hurry. The perception on the part of the person providing food is that the person eating is ready to be fed the next bite and at the smallest sign of the person opening their mouth, they extend the food for it to be taken off of the utensil. The result is that every bite is rushed. The person being fed does not chew each mouthful as long as they might choose and they swallow larger lumps than is wise. This pace throughout the meal degrades the enjoyment of the experience and, in many cases, makes it a stressful time.

Even with a heavy workload, a care provider should take a little extra time with each resident that they serve at mealtimes and make the dynamics of the meal entirely different. It can become a relaxing experience that the care recipient looks forward to. By adding just a few minutes to the time spent providing food, the mealtime can be enjoyed far more.  Also, it is easier to digest food that has been better chewed and, therefore, the person being fed is less likely to develop indigestion after the meal.

A tip to slowing down the pace at which you feed someone is for the caregiver to remove the spoon or folk from their hand between bites. Once the food recipient has a mouthful of food, put the utensil down on the plate. Only pick it up again when they have swallowed the bite of food. This changes the message being sent from, “hurry up and eat” to “take your time”.

Another way of making the mealtime experience more enjoyable is to socially interact with the resident. Even if they are distracted by long conversations, a small interaction about the weather, or some other light hearted comment, can make the difference between a pleasant situation and an “all business” atmosphere. If care providers are aware of the importance of meals to the people they look after, they can significantly contribute to it being a good time, regardless of what is being served. The mealtime caregiver (who we refer to as their mealtime partner) is equally as important as the food that they serve to the quality of the meal.

Remember that the Mealtime Partner Dining System can lessen the workload for care providers and allow its user to eat at the pace that they choose. (The Mealtime Partner is very patient. It will never hurry the person using it.) Thus both the care recipient and care provider benefit from its use. And, when time for meals is limited, having a Mealtime Partner Dining System for the residents who cannot feed them self, can allow a single caregiver to feed several people at the same time without reducing the quality of the care being provided. For more information about the Mealtime Partner Dining System, click here, and/or call us at 800-996-8607.


Did You Know? Did you know that all baby bottles and Sippy cups sold in major chain stores in the United States are now “BPA-free” (i.e., bisphenol A). According to Sarah Janssen, Senior Scientist at the Natural Resources Defense Council (NRDC) this change came about, not because the FDA banned the use of BPA in polycarbonate bottles and cups, but because consumers demanded that the products be BPA-free. BPA is a hormone-disrupting chemical that mimics estrogen that has been linked to reproductive and developmental harm. Even though BPA is no longer used in bottles and Sippy cups, it is still used in many other products including the lining of some cans, including some baby formula cans. Therefore, it is advisable to check labels of containers to be sure they are BPA-free. Also, don’t be tempted by deeply discounted bottles and Sippy cups sold by cut-rate stores as the leftover products containing BPA may still show up as they are not actually banned from sale.

The Use of Prosthetics for Eating

Independent eating is a complicated function involving many parts of the body and a good deal of coordination. Contemplate just what takes place when a cracker is picked up and placed into someone’s mouth. First the eyes have to judge where the cracker is and send a message to the brain to move the hand to the location of the cracker. Once the hand arrives at the location, the brain must instruct the fingers to assume the appropriate positioning to grasp the cracker. The appropriate pressure of the fingers must be included in this instruction set, otherwise the cracker will shatter and all that will be left is crumbs.

Once the cracker is grasped between the fingers and thumb, it must be lifted toward the mouth. This requires more instructions to be sent from the brain to the hand, forearm, wrist, upper arm and shoulder. On arrival at the mouth the cracker must be placed into the mouth and the lips first must open and then close. The teeth or gums must bite a piece of cracker off of the whole cracker and the piece must be chewed and then swallowed (which is another complete set of instructions and another topic which we will not discuss here).

Now revisit this scenario and remove normal hand or arm function, or both. A complicated sequence of events looks impossible without some form of physical aid, or assistive technology. For those with impaired arm and/or hand function, therapists usually try a wide variety of equipment that is commercially available to see if they can provide adequate assistance for the person to begin self-feeding.

However, for those who have missing limbs, the circumstances are very different from those who have malfunctioning limbs. When limbs are missing either a prosthetic must be developed, or some type of adaptive device (a splint or shoulder harness with a utensil attached) that can be mounted on the end of the missing limb/s must be acquired if the individual is going to have any potential for feeding them self. Also, depending upon where the limb ends (above the wrist, above the elbow, etc.) dramatically impacts how an aid, or prosthetic device, can be attached and controlled or operated. Also, if a person is born with a missing limb or limbs, it is a different learning situation from those who have had limbs that have been amputated. Yet, in either case, self-feeding remains a difficult task to master for those with missing limbs.

The world of prosthetics is changing rapidly and amazing developments are underway. Lower limb prosthetics are highly sophisticated and return many lower limb amputees to functional walking and running. Much of the research undertaken to develop these limbs has been carried out to address the needs of “wounded warriors” who are returning from active combat with missing limbs.

The development of upper limb prosthetics is also being studied and several new limbs are being developed. However, the development of upper limb prosthetics lags behind that of lower limb prosthetics. Much of this is due to the complexity of arm and hand movement. The human arm has 22 degrees of freedom, which, in itself, is an amazingly complicated requirement to duplicate. To add to the difficulties of developing an arm and hand that can replicate the human arm and hand movement is the need for an artificial arm to be light-weight (an average woman’s arm weighs about 3.6 kg or 7.94 pounds). Because of these requirements prosthetic arms have remained about the same for decades. The old arms offer 3 degrees of freedom: the elbow can move up or down; the wrist can do the same; and a hook (or similar device) can be opened and closed. In many cases, these arms cause discomfort where the socket attaches to the body. They become sweaty and slip, and, therefore, the connection is not reliable. In many cases the user abandons the artificial limb because of its limited function and discomfort. Six thousand people require arm prosthetics in any given year and their needs are different depending upon where their amputation occurred (at the shoulder, below the elbow, etc.)

Some research is being conducted at the Rehabilitation Institute of Chicago where nerve fibers from the end of the arm are being rerouted to connect to the pectoral muscles. Thus the brain can send signals to the phantom arm and the signal can be felt in the pectoral muscles. Electrodes can be attached to the chest and can transmit the signals to an artificial arm that can execute the instruction sent by the brain. This has potential for limbs that are controlled by the user simply thinking about what they want their artificial arm or hand to do. However, this technology is many years away from being a commercial product, and of course will require the amputee to go through surgery to move the nerve endings.

Potentially, closer to being available is a prosthetic arm called the “Luke arm” (named for Luke Skywalker in Star Wars) being developed by Deka Research and Development Corp., (a company owned by the creator of the Segway). The Luke arm has 18 degrees of freedom and is controlled by the user’s feet. The arm, as well as being far more capable than its predecessors, provides feedback to the user as to the amount of grip being applied to an object, thus allowing the user to hold something with the fingers without crushing it. The Defense Advanced Research Projects Agency (DARPA) provided the initial funding for the Luke arm. If further funding can be found, the Luke arm will go through clinical trials as its next step. To see a video of the Luke arm, click here.

Artificial arms of the future will allow amputees to do almost anything that they would have done with their natural arm or hand. But that is many years away. Currently, artificial arms only allow for relatively gross movement and the fine movement necessary for independent eating using prosthetics is unavailable for most amputees.

To add to the limits of prosthetics, only one company in the United States specializes in developing upper limb and hand prosthetics for infants and children. The prosthetics are called the Myoelectic Arm and Hand. These prosthetics sense the signals sent from the brain to the end of the limb and can interpret them into movement of the prosthetic. Each prosthetic costs approximately $25,000 and must be modified as the child grows. However, for some children these limbs work well and provide function that is not available with just the residuum (the end of the limb). However, these arms also lack the fine movement required for self-feeding.

At mealtimes, as a stop-gap measure for young children who have missing upper limbs or hands, it is not uncommon to have the child eat food directly off of the tray of their high chair by lowering their mouth to the food. If this method is used, it is recommended that the surface from which they are eating be raised enough that the child does not bend their back and neck all the way down to waist level because this will cause stress on those areas of the body. This method allows a child to develop the concept of independent eating but it should only be temporary as it is too stressful for the long term and will lead to damage to muscles and joints over time. The only thing that is gained from eating in this manner is that it is “independent eating” rather than being fed. This method of eating is used by adults who have congenital upper limb loss, because in earlier generations of people born with missing upper limbs, it was the only way that they could eat independently. However, adults who have lost upper limbs having had functional hands and arms, rarely use this method to eat.

For anyone with missing or poorly functioning or non-functioning hands and/or arms an easy solution to independent eating is a device specifically designed for eating, such as the Mealtime Partner Dining System. Even children as young as three years old can use this type of dining system and can gain the kind of mealtime independence that is normally acquired by children of that age. For everyone who is dependent upon another person at mealtimes, the Mealtime Partner Dining System is an easy solution to feeding themselves.


Child Using The Mealtime Partner Imagine sitting down to Thanksgiving Dinner with family and friends and your family member, who last year was fed, eating their meal independently. The Mealtime Partner Dining System empowers its users to be able to feed themselves. No longer must they wait to be fed, instead they can enjoy their meal at the pace they choose, with everyone else. What a wonderful way to celebrate the Thanksgiving feast - together! Click the following link below to learn more about how to gain mealtime independence for those who cannot feed themselves.
The Mealtime Partner Dining System is quick and easy to learn and has no complicated programming requirements. Each Dining Systems comes with a complete training video on DVD so new users and caregivers can learn to use it in just a few minutes. To view a list of the instructional videos that may be selected by title, click here.

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