SAFE EATING

Environment

• Calm and as ordered as possible
• Reduce distractions that make concentrating on eating and drinking difficult
• Turn down or off music and TV, reduce other noises as much as possible
• Face person away from residents or external events that interfere with mealtimes if necessary
• Sit with the person during meals to provide social interaction, communication and modelling of behaviour

Positioning

• Allow for a more normal body posture
• Help to optimize stability and the person’s ability to participate in a meal
• Help produce a chin tuck – enables gravity to keep the food toward the front of the mouth until the person is ready to swallow it
• Guard against material entering the respiratory system
• Help to control reflux. If contents of the food pipe and stomach are allowed to back up into the throat area, aspiration can occur

Guidelines for chairs or wheelchairs

• Upright and centred
• Not leaning excessively to one side
• Pelvis, buttocks and back touching the chair back to prevent slipping
• Back should be straight or slightly forward
• The seatbelt should be secured
• Feet resting on the wheelchair’s footrests
• Inactive arms supported on the wheelchair tray or a pillow
• Head positioned so that the neck is slightly flexed

Positioning for the person following a meal

• Wheelchair or chair: remain upright for at least one hour
• Bed bound: lower the head of the bed slightly (from an upright 90 degree angle lower to no less than 60 degree angle)
• Gravity: assists the downward progress of the meal reduces reflux that may cause aspiration pneumonia

Feeding strategies: physical guidance

• Place the food on the spoon and then hand it to the person, if the person cannot get the food onto the utensils properly
• Hand the cup to the person if the person cannot reach for the cup on their own.
• Hand finger foods to the person if help is needed to pick them up
• Initiate and then allow the person to take over if the person needs help to begin eating.
• Take turns with the person in getting the food to the mouth. Alternating allows the person the opportunity to participate, learn from your actions, and receive additional support
• Provide hand over hand assistance by gently putting your hand over or around his/her hand to hold the utensil or move the hand to the mouth
• Gently touch person’s forearm to alert. Touching the forearm during meals has been shown to increase food intake

Your role as a team member

• To follow the mealtime prescription
• To provide nourishment
• To help the person be as independent as possible and maintain his/her dignity
• To be an active participant in the person’s eating experience
• To learn the person’s mealtime style
• To watch, listen & report any day-to-day changes in a person’s swallowing
• To ask for advice if you have difficulty following recommended feeding strategies

Amount of assistance

Observe…

• Person is independent
• Requires observation to ensure safety at meals

Supervise…

• Requires assistance at beginning of meal, such as setting up and positioning
• Requires observation throughout the meal
• Often needs prompts to follow safe eating/drinking strategies

Partial Assistance…

• Independent
• Needs verbal or physical prompting throughout the meal to ensure safety is maintained

Full Assistance…

• Total assistance with all aspects of the meal

For more information on this service, or for a full colour poster on this material, please contact Wellness & Lifestyles on 8331 3000 or