meal environments that thrive! a look at feeding techniques and eating aides amey herald, m.s., r.d....
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MEAL ENVIRONMENTS MEAL ENVIRONMENTS THAT THRIVE!THAT THRIVE!
A look at feeding techniques A look at feeding techniques and eating aidesand eating aides
Amey Herald, M.S., R.D.Amey Herald, M.S., R.D.
CACFP Program ConsultantCACFP Program Consultant
Nutrition and Health ServicesNutrition and Health Services
How can we help ADC clients How can we help ADC clients enjoy their meals so that they can enjoy their meals so that they can maintain proper weight and remain maintain proper weight and remain
in good health?in good health?
AssistanceAssistance
Opening food packages and cutting foods Opening food packages and cutting foods into bite-size piecesinto bite-size pieces
Some participants may need to be fedSome participants may need to be fed
Others may need verbal or physical cueing Others may need verbal or physical cueing
AssistanceAssistance
Staff alertness and conversationStaff alertness and conversation
Employees should anticipate clients’ Employees should anticipate clients’ needsneeds
Dining Room AtmosphereDining Room Atmosphere
ColorColor
Make sure clients can see the plate ( i.e., Make sure clients can see the plate ( i.e., avoid a white plate on a white tablecloth)avoid a white plate on a white tablecloth)
Choose contrasting colors for placemats, Choose contrasting colors for placemats, napkins and dishesnapkins and dishes
Avoid distractions during meals like noise Avoid distractions during meals like noise or TV/radioor TV/radio
Dining Room AtmosphereDining Room Atmosphere
A comfortable temperature A comfortable temperature for the clientsfor the clients
Ask the clients and watch non-verbal signsAsk the clients and watch non-verbal signs
Be aware of drafts and ventsBe aware of drafts and vents
Offer a blanket or sweater to clients who Offer a blanket or sweater to clients who are cold or open a window near areas that are cold or open a window near areas that are stuffyare stuffy
PositioningPositioning
Key to maximizing eating independenceKey to maximizing eating independenceArm rests of the chair should slide Arm rests of the chair should slide comfortably under the tablecomfortably under the tableFeet planted firmly on the floor or foot Feet planted firmly on the floor or foot supportssupportsDining table may need to be elevated to Dining table may need to be elevated to allow for wheelchair arm supportsallow for wheelchair arm supportsPoor sitting balance or neck control- refer Poor sitting balance or neck control- refer to Rehab. Therapist for aids and strategiesto Rehab. Therapist for aids and strategies
Verbal CuesVerbal Cues
Steps In EatingSteps In Eating Picking up utensilPicking up utensil Scooping the foodScooping the food Taking to mouthTaking to mouth ChewingChewing SwallowingSwallowing Returning the utensilReturning the utensil
Staff RapportStaff Rapport Call by his/her nameCall by his/her name Eye contactEye contact Calm, soothing voiceCalm, soothing voice Two-choice questionsTwo-choice questions Give praise freelyGive praise freely RepetitionRepetition
Physical CuesPhysical Cues
Hand over hand assistanceHand over hand assistance
(Such as picking up the milk carton, or directing food to (Such as picking up the milk carton, or directing food to the mouth)the mouth)
Do not provide more assistance than is neededDo not provide more assistance than is needed Use physical cues in addition to verbal cuesUse physical cues in addition to verbal cues
Adaptive Eating EquipmentAdaptive Eating Equipment
First - check to make sure that poor First - check to make sure that poor positioning is not the problempositioning is not the problem
Training from Rehabilitation Therapist - for Training from Rehabilitation Therapist - for the client and the ADC staffthe client and the ADC staff
Staying CleanStaying CleanNapkins and clothing protectorsNapkins and clothing protectorsIf client objects to a clothing protector, If client objects to a clothing protector, offer a large napkin that can be tucked in offer a large napkin that can be tucked in shirtshirtHave moist, disposable washcloths handyHave moist, disposable washcloths handy
Proper positioning, use of adaptive equipment and cueing will help reduce spills!
How can we help ADC clients enjoy How can we help ADC clients enjoy their meals so that they can their meals so that they can
maintain proper weight and remain maintain proper weight and remain in good health?in good health?
AssistanceAssistanceDining Room AtmosphereDining Room AtmosphereVerbal CuesVerbal CuesPhysical CuesPhysical CuesAdaptive EquipmentAdaptive EquipmentRehabilitation TherapistsRehabilitation Therapists
AnswersAnswers
1 cup milk- 7 oz. are from fluid. About 1 1 cup milk- 7 oz. are from fluid. About 1 oz. is from milk solids.oz. is from milk solids.1 slice white bread- very small amount of 1 slice white bread- very small amount of moisturemoisture½ cup applesauce- about 3 oz. are fluid. ½ cup applesauce- about 3 oz. are fluid. About 1 oz. is from apple solids.About 1 oz. is from apple solids.1 cup tomato soup-about 7 oz. are fluid. 1 cup tomato soup-about 7 oz. are fluid. About 1 oz. is from tomato solids.About 1 oz. is from tomato solids.1/2cup gelatin- ½ cup fluid1/2cup gelatin- ½ cup fluid
AnswersAnswers
1 cup plain yogurt- about 6 oz. are fluid. About 2 1 cup plain yogurt- about 6 oz. are fluid. About 2 oz. are from milk solids.oz. are from milk solids.½ cup green beans- about 1.5 oz. are fluid and ½ cup green beans- about 1.5 oz. are fluid and 2.5 oz. are green bean solids2.5 oz. are green bean solids1 cup orange juice- about 7 oz. are fluid. About 1 1 cup orange juice- about 7 oz. are fluid. About 1 oz. is from orange solids/pulp.oz. is from orange solids/pulp.2 Tbsp. Peanut butter- very small amount of 2 Tbsp. Peanut butter- very small amount of moisturemoisture2 oz. cottage cheese- about 1 oz is fluid and 1 2 oz. cottage cheese- about 1 oz is fluid and 1 oz. is milk solids.oz. is milk solids.
AnswersAnswers
Whole wheat bun with sesame seeds - Whole wheat bun with sesame seeds - serve whole wheat bun without seedsserve whole wheat bun without seeds
High bran cereal - soak in milk to softenHigh bran cereal - soak in milk to soften
Brown rice - serve with gravyBrown rice - serve with gravy
Peanuts - serve PB or use PB as an Peanuts - serve PB or use PB as an ingredient for a baked product ingredient for a baked product
Raisins in oatmeal - cook raisins with Raisins in oatmeal - cook raisins with oatmeal to break down fiberoatmeal to break down fiber
AnswersAnswers
Dried apricots and prunes - stew apricots Dried apricots and prunes - stew apricots and prunes together and serve hotand prunes together and serve hot
Apple wedges with skin - remove skin of Apple wedges with skin - remove skin of apple. Serve applesauce or baked appleapple. Serve applesauce or baked apple
Melon wedges - cut in bite-sized piecesMelon wedges - cut in bite-sized pieces
Blueberries, fresh - bake blueberries into Blueberries, fresh - bake blueberries into muffinsmuffins
Peach with skin - Remove skin from peachPeach with skin - Remove skin from peach
AnswersAnswers
Corn on the Cob - Cut corn off the cob. Corn on the Cob - Cut corn off the cob. Serve cream styleServe cream style
Raw carrots - cook carrots until fork-tenderRaw carrots - cook carrots until fork-tender
Broccoli spears - chop broccoli spears and Broccoli spears - chop broccoli spears and cook until fork-tendercook until fork-tender
Raw spinach - cook Raw spinach - cook
Sliced tomatoes - remove skin; may need Sliced tomatoes - remove skin; may need to serve cooked tomatoes insteadto serve cooked tomatoes instead
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