Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

April 2016 Independent Eating and Drinking Newsletter

	April Topics: Positioning for Eating Eating Versus Being Fed
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Introduction

Mealtime Partners newsletter is published once a month, and the topics that are covered relate to eating and drinking safely, and independently. Some basic topics are extremely important to safe eating and drinking for those who have difficulties feeding themselves or taking a drink without help. Because of the fundamental importance of these subjects we are going to revisited some of them. In the next few months our newsletter will reexamine some issues that were covered several years ago. This month we are going to discuss seating and positioning during eating. The same information should be considered when someone is taking a drink, however, because we hope that everyone is drinking throughout their day, not just at mealtimes, it is sometimes more difficult to adhere to the same positioning practices used during meals. It should always be remembered that the head should be level or tipped a little bit forward while drinking.

Positioning for Eating

Everybody performs numerous tasks every day and for each task the body is positioned and adjusted for ease of task performance. Eating is one of the tasks that we perform several times a day and able-bodied people unconsciously adjust the position of their body to prepare for eating, and make ongoing adjustments throughout the meal for optimal positioning for eating. Not only do we move our bodies forward and back for each bite of food but we also change the position of our feet many times during each meal to stabilize our trunk. These movements fine-tune our body posture for us to eat comfortably and safely. For many individuals who are unable to feed themselves, adjusting their position for eating is either very difficult or impossible, and they must depend upon their caregiver to position them.  

The correct seating and positioning of the body during eating is very important because it improves both the safety and the enjoyment of the meal and facilitates better digestion. A good position for eating requires the trunk to be very stable. To enable the trunk to be stable, the feet must have firm support so that they can bear weight as the person eating, moves throughout the meal. Additionally, the thighs and buttocks should bear weight. When the feet, thighs and buttocks bear weight, the body becomes more stable and the shoulders, arms, and head are able to maintain a more constant, steady position. This will promote better control of not just the head and neck, but all of the muscles in the jaw, tongue and mouth. The overall result is that the person will eat more safely and gain better control over eating. Read the entire article....

.... Finally, here is a tip for those who feed someone. You too need to be in a specific sitting position to meet the feeding needs of your dining partner. If you stand up while feeding someone, their head will automatically tilt upward to accommodate the position of your arm. This head position puts them at an unnecessary risk of aspiration because their airway protective mechanisms are less effective with their head raised. It is better, when feeding someone, to sit directly in front of them, facing them, and to present the food to them at the level of their lower lip when their head has an adequate chin tuck. Sitting to the side of the individual, tends to induce the person to turn their head towards the utensil and they are no longer in an ideal position to receive food into their mouths.

Conclusion: The overall objective of good positioning for eating is to provide the body enough stability that the muscles involved in eating can perform at their best. With a stable body, people are able to better control their muscles and therefore they are able to chew more productively, manipulate the food in their mouth with greater ease and swallow safely. Eating in the right position over an extended time can result in improved muscle tone and thus better overall oral motor control.

The Mealtime Partner Dining System
For individuals who are unable to feed themselves because of limited or no hand and/or arm function, the Mealtime Partner provides them a way to eat independently. This lets them experience an enjoyable mealtime that is totally under their control. They can choose what they eat for each bite and pace their eating to suit their own needs and desires.
The Mealtime Partner Dining System can be positioned to meet the specific needs of each user. The user does not have to adjust their position to eat using the device because the Partner’s flexible mounting systems permit positioning to fit the user's needs, making mealtimes a comfortable, relaxed experience, with the user positioned safely for eating. The Mealtime Partner empowers its user to eat what they want, when they want it. The Mealtime Partner Dining System is quick and easy to learn and has no complicated programming requirements. Each Dining System comes with a complete training video on DVD so new users and caregivers can learn to use it in just a few minutes. There are no other assistive dining systems that meet the needs of the users, like the Mealtime Partner. For more information about this device, click on this link. To talk to a representative call: 800-996-8607, or email us at: xxxxxx@mealtimepartners.com and we will be happy to assist you in selecting the best system to meet your needs.

Eating Versus Being Fed

Recently the question was raised, how do you stop feeding someone who has been fed for years, and allow them to actively eat at mealtimes? First, the difference between what is meant by feeding and eating must be clarified. Many people are dependent upon another person to receive all of their nutrition; however, some of these individuals are fed and others eat. The difference is how food gets into their mouth. When fed, the person providing mealtime support puts each bite of food into the person’s mouth. If the individual eats, they are offered a bite of food, but the person eating takes the food off of the utensil, into their own mouth, at their own pace. The advantage of eating versus being fed is that it is a safer way to receive food. If a person chooses when each bite of food enters their mouth, they are less likely to choke on the food or to aspirate. (There are approximately 40,000 deaths in the U.S. each year due to aspiration pneumonia. One of the best predictors for the development of aspiration pneumonia is being fed by others.) (Calhoun, Wax & Eibling¹, DeLegge²).

For those who are fed, old habits are usually well established and body movement patterns have become second nature. For example, many people who are fed lean slightly backwards throughout the meal. When in a slight backward recline, their mouth is at an easy angle to receive a spoonful of food and the food is unlikely to fall out of the person’s mouth after it has been put in their mouth. When in a reclined position the chin naturally is raised. Often this position has remained from early childhood. It is common for infants to be “tilted” backwards when they are fed. Some people lean as far forward as they can. They move as far towards the spoon as they possibly can. This is commonly a result of a desire to eat (hunger) or to be helpful to the person feeding you. Both of these positions hamper the person’s ability to eat. Read the entire article....

.... Great patience is required and must be exhibited on the part of the feeding partner as the ability to eat is learned. Impatience in the feeding partner is easily sensed and the person trying to learn often hurries and the pleasure and pride of acquiring a new skill is diminished and sometimes simply abandoned because they sense the frustration of their mealtime partner.

Regardless of whether someone is eating with a person providing the food, or using dining equipment like the Mealtime Partner Dining System to eat, it is always safer to eat rather than being fed, because eating diminishes the risk of choking or aspiration when the person eating controls each bite of food placed in their mouth.