April 2019 Independent Eating and Drinking Newsletter
| Independent Eating and Drinking are Wonderful |
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The Social Impact of Independent Eating
Mealtimes are generally a social time with family or friends together sharing food and talking. However, if you are being fed, you are unlikely to fully participate in the ongoing conversation because you must always anticipate receiving a bite of food. If you open your mouth to speak, your feeding partner could easily (unintentionally) put a bite of food in your mouth when you are not ready, not knowing that you are about to talk. The result of this situation is that those being fed are usually not able to fully participate in the social interactions surrounding a meal. They are more likely to be passive participants listening to the conversation rather than fully participating. When feeding yourself you choose when to talk and when to eat.
For residents of institutions mealtime conversations are unlikely. While they are being fed, usually quickly (because staff often have several people to feed at each meal), staff will talk to one another but typically interact only briefly with the person they are feeding. The interactions are mostly related to eating. In this situation the person being fed is deprived of the normal mealtime social experience. (It should be noted, however, that people who have swallowing difficulties should refrain from talking and eating at the same time. A speech language pathologist should advise them about the best practices to follow at mealtimes. The training should always be adhered to until the swallowing problems abate.)
When empowered to feed themselves using assistive technology (AT), verbal interactions have been observed to change. For children, who have never experienced mealtime independence, the change is gradual. As they realize that they can choose when to speak and when to eat, they are more likely to join in the conversation. For those regaining independence through the use of AT, conversation returns to a normal pattern almost immediately.
Being fed imposes an unusual constraint on both the feeding partner and the person being fed as conversation may become entirely related to the food being eaten rather than a true social interaction. Food selection for those being fed is a difficult issue for a feeding partner. Either they must choose what food is fed for each bite or they must ask the person being fed what they want for every bite. Most commonly the person providing food makes all of the decisions about what will be offered and the pace at which it is provided. Even the very best feeding partners have difficulty matching how they provide each bite of food with what the person they are feeding might like. A good example of this is a wife who fed her husband and carefully provided him each bite with a mixture of food on the utensil (e.g., potatoes and meat, or green beans and tomato). When her husband was able to eat independently by using an assistive dining device, he ate all of his potatoes, next all of his green beans, and finally the meat. His wife was astonished and felt that he was still having difficulty with feeding himself. When the couple discussed this, the husband explained that he was so appreciative of her care that he could not possibly impose upon her further to change how she selected the food that she was feeding him, but that he really preferred that his food not be mixed.
Many children who have never experienced independence at mealtimes, eat whatever is offered to them showing little regard for the flavor. Either they do not realize that they have a choice, or they simply accept that some food doesn’t taste as good as other food, but they believe that they should eat it, regardless. (No clinical explanation of this behavior has been established.) What has been observed is that if independence is gained, food selection and the pace of eating often changes dramatically. On many occasions, it has been observed that a child who has always eaten all of his or her vegetables, for example, when using a Mealtime Partner Dining Device (and can therefore make his/her own food selection), suddenly rejects (i.e., never selects) a specific vegetable, even though all of the family members and caregivers were adamant that the child liked that particular food item. Additionally, the pace at which people eat will change when they are able to control the pace through the use of AT. People diagnosed with gastroesophageal reflux disease have been observed to dramatically slow their pace of eating, in some cases doubling the time spent eating. It should also be noted that they experienced less discomfort after their meal when they ate at a slower pace.
Conclusion. Eisemann Shimizu1, et. al., concluded that for people who are totally dependent on a caregiver to feed them, “the joys of eating and being able to eat by oneself are taken away from him/her. This can lead to feelings of shame, discomfort, loss of appetite, decreased self-esteem and panic or fear”. For those living in a supportive family environment, these findings may not be applicable. Nevertheless, for those who lack the ability to feed themselves, the goal should be to have them participate as fully as possible in eating, not only for reasons defined by Shimizu, but for the many other reasons discussed in this and previous Mealtime Partners Newsletters.
| A Hands-Free Drinking System to Meet Everyone's Needs | |
| A hands-free drinking system
can enable everyone with the ability to create suction to drink independently throughout the day. Mealtime Partners, Inc. has several different types of hands-free drinking systems from which to choose: the Hydration Backpack with Drinking Tube Positioning; the Front Mounted Drinking System; and the Drink-Partner. They can all be easily attached to a bed or wheelchair and can be positioned to meet the individual user’s need. |
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Hydration Backpack with Drinking Tube Positioning (i.e., for Manual Wheelchairs) |
Hydration Backpack with Drink Tube Positioning for Slide Track |
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| Front Mounted Drinking System for Wheelchairs with Slide Track | Front Mounted Drinking System for Manual Wheelchairs |
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| Drink-Partner Mounted on a Wheelchair Handle | Drink-Partner for Slide-Track |
To view all of the Mealtime Partners drinking products, click here. Remember Mealtime Partners drinking products can be attached to powered wheelchairs with slide-tracks, manual wheelchairs with handles and/or tubular frames, or hospital beds with plastic or metal bed rails. For additional guidance about how to select the appropriate drinking system for your specific needs, click here. |
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Clamping Products for Slide-Track
The majority of new powered wheelchairs have track mounting systems on them. These tracks are mounted on a variety of locations on wheelchairs and are used to attach various components of the wheelchair to the basic chair structure. In addition to mounting wheelchair parts to the chair, the tracks also allow various pieces of equipment to be added to the chair. There are two distinct types (or sizes) of tracks on wheelchairs currently in use: most wheelchair manufactures use “standard” tracks which are a single track; Permobil uses a double track system that they call “UniTrack”. The slots in standard tracks are larger than those in UniTrack. In both cases, a T-shaped object with threaded holes (which are commonly called T-Nuts) are used to fit into the slot. The peripheral components then screw into the T-Nuts. Figure 1 shows the difference in size of the two types of T-Nuts. The Standard T-Nut is on the right of the picture and the one for UniTrack is on the left.
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| Figure 1: UniTrack (left) and Standard T-Nuts |
| Standard T-Nuts are considerably larger than the T-Nuts for UniTrack and, therefore, cannot fit into the slots in the UniTrack rails. |
Mealtime Partners drinking, and mounting products can be mounted on either type of track. However, when ordering it is necessary to specify the type of wheelchair to which the part will be mounted. An additional feature is available on these slide-track products. The peripheral components can be mounted either vertically or horizontally, relative to the track. This article will use the example of our Attachment Holder (Mealtime Partners part number 4973) to explain how the orientation of the part can be changed. It should be noted, however, that this same methodology applies to all of our parts that are designed for track mounting.
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| Figure 2 - Mealtime Partner Attachment Holder |
This allows the orientation of the part to be dictated by which two holes are used to mount the T-nut that is used to attach the part to the slide-track. For example, if the part shown in Figure 2 is to be mounted in the vertical orientation in which it is shown, the two center holes would be used to attach the T-nut. If the part is going to be mounted with the Thumb Screw to the left or right, the T-nut would be mounted using the top and bottom holes.
Figure 3 shows two Flex Arm Holders with T-Nuts mounted in the different orientations. Either type of T-Nut can be mounted on any of the Mealtime Partners parts that have “slide-track” in their name. (Just be sure the correct size is specified to fit the slot in your track rail.)
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| Figure 3 - Attachment Holders with T-Nuts for Mounting with different Orientations |
Using the same principle, Figure 4 shows the Mealtime Partners "Flex Arm Holder for Slide-Track with Knobs" mounted on UniTrack in the two different orientations.
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| Figure 4 - Mealtime Partners Flex Arm Holders Mounted with two different orientations. |
If you need further information about mounting our products on Slide-Track, please call or email Mealtime Partners at: 800-996-8607, or questions@mealtimepartners.com.
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Did you know? Did you know that the ALS Association, which was founded in 1985, and is the preeminent organization supporting research and clinical management programs for Amyotropic Lateral Sclerosis (ALS), recently published a white paper reporting on the relationship between ALS and military service? The paper states: “Existing evidence supports the conclusion that people who have served in the military are at a greater risk of developing ALS and dying from the disease than those with no history of military service. As outlined in this paper, study after study continues to demonstrate this to be true: If you serve in the military, regardless of the branch of service, regardless of whether you served in the Persian Gulf War, Vietnam, Korea, or World War II, and regardless of whether you served during a time of peace or a time of war, you are at a greater risk of dying from ALS than if you had not served in the military. The questions we are asking today are these: Why is there a greater risk of ALS with military service? And what are we, as a nation, going to do about it?” Both a summary document and the full report are available at the ALS Association website. |
References: 1. Eisemann Shimizu, M., Otsuka, A., Kania, S., Oki, S. The Therapeutic Effects of Independent Eating for the Severely Physically Disabled. Journal of Phys. Ther. Sci. 16: 73-79, 2004.