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

Quiz:Quiz:Can You Guess The Fluid Can You Guess The Fluid

Content?Content?

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.

Quiz:Quiz:High Fiber FoodsHigh Fiber Foods

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

Pick Up Goodies in Back of Pick Up Goodies in Back of Room Today!Room Today!

ADC Resource Manual and ADC Resource Manual and Lesson PlansLesson Plans

Answer sheets to quizzesAnswer sheets to quizzes