12.7.2: Procedure- Assisting with Eating

1. Inform the patient that it is mealtime. Provide choices about foods.
2. Always wash and dry your hands. Always apply gloves during meal preparation and when assisting with eating.
3. Assemble equipment needed (e.g. bowl, plates, cup, eating utensils, napkins).
4. Allow the patient to select foods they prefer.
5. Prepare the patient’s environment by ensuring there are no unpleasant odors or sights.
6. Offer mouth care prior to eating. Assist with applying dentures. This allows a patient to be able to effectively chew their food. Assist or encourage the patient to put on glasses so they may see their food.
7. Position the patient in a high upright sitting position. This will prevent the patient from choking or aspirating food or fluids.
8. Allow the patient time to pray before eating if they wish.
9. Arrange food attractively on the plate.
10. Encourage the patient to do as much as they are capable. Assist only as needed.
11. Cut food into small, bite-sized pieces if patient is unable to do so.
12. Place a napkin under the patient’s chin. Replace soiled napkins as needed.
13. Inform the patient of food temperatures, especially for food that is hot.
14. Use forks and spoons gently when feeding the patient. Never force feed a patient.
15. Allow adequate time between bites before offering the next bite.
16. Encourage the patient to chew food well before proceeding to taking the next bite.
17. Mealtime is a good time for Home Health Aides/Personal Care Aides to get to know their patient. Make eating time a pleasurable experience. Be patient. Sit next to or facing the patient if assisting with feeding or while providing company during meal times. Allow the patient to eat alone if they prefer. Check on them every 5-10 minutes.
18. For patients who have swallowing problems, Home Health Aides/Personal Care Aides should limit their conversation while the patients are chewing. They may need to concentrate on chewing and swallowing their food appropriately.
19. Encourage, or assist, if needed, wiping of the mouth or face.
20. Use straws or training cups as appropriate to allow ease of drinking and promotion of independence.
21. Special plates with guards and padded eating utensils help to promote independence.
22. Remove uneaten food, liquid, and soiled dishes once the patient is done eating. Clean the patient’s area and all used dishes.
23. If the patient has swallowing problems, keep them in an upright position for 30-60 minutes after eating to prevent choking or aspiration of food or fluids.
24. Offer hand and mouth hygiene when the patient has finished their meal.
25. Remove your gloves. Wash and dry your hands.
26. Document completion of the task and record any changes in condition or behavior. Report any chewing or swallowing problems. Report any changes in appetite. Record amount of food eaten and fluids taken in as intake.

Special Needs

1. If the patient has a sensory impairment, such as a vision problem, tell the patient where the food is located on the plate using a clock to inform them of food position. For example, “The mashed potatoes are at the 6:00 position, the meatloaf is at 3:00 and the green beans are at 9:00.”
2. If the patient has facial weakness or arm/hand weakness or paralysis, feed the patient to their strong side and/or place eating utensils on their stronger side.
3. If the patient has a swallowing problem, allow longer periods between bites for adequate chewing. Limit the amount of conversation while the patient is chewing or swallowing. Ensure that the food is cut into bite sized pieces and that food is the appropriate consistency (e.g., pureed), according to the patient’s prescribed diet.
4. Special plates, utensils, and cups are available to assist the patient who is weak or who has trouble grasping utensils. Eating utensils can be built up by using gauze taped around the handles.