Requiring assistance to eat daily meals puts residents in a vulnerable position. A great deal of tact and constant communication are needed from the healthcare staff providing this care.
There are steps you can take to make a resident’s mealtime as dignified and as seamless as possible.
Alarmingly, unplanned weight loss and malnutrition are rife among older adults in residential aged care (Leading Nutrition 2019), with about half of all aged care residents being either malnourished or at risk of malnutrition (DAA 2019).
Another factor to consider is that older people have weakened immune systems and may have a heightened fear of food poisoning or food complications, making them reluctant to eat food they have not prepared themselves.
One simple way to increase the likelihood of a resident receiving the nutrition they need is to play an active role in their mealtime. In doing this, you are able to observe that:
The meal is properly cooked and prepared
The resident is finishing the meals.
This article will outline methods of providing effective meal assistance in aged care facilities.
The level of assistance required by clients will vary.
This can range from:
Supervision, prompting and encouragement
Setting up cutlery etc.
Cutting up meals
Full feeding assistance.
(Eat Well Nutrition 2014)
Before the Meal
It may seem obvious, but check that the meal is correct for the resident.
Ensure the meal has been heated well and is the right consistency.
Check that tables and trays are set up to suit the resident and appropriate utensils are available. Adjust these as necessary.
Ensure that the resident has all the aids they require for mealtime, for example, dentures and glasses.
(Aged Care Guide 2014; Eat Well Nutrition 2014)
During the Meal
Talk to the resident about the meal they’re about to eat. It is particularly important to explain what the food is when the meal has been puréed or modified to facilitate chewing/swallowing/digestion.
Ask the resident if they would like a cloth or clothing protector, altered utensils or any other item that would make them feel more comfortable during mealtime.
Ask the resident if there is something particular on the plate they would like to eat.
Always let the resident know what you are doing and identify what the food is before serving it to them.
Make conversation with the resident if appropriate.
Refrain from talking to other people while you are assisting a resident. Do everything in your capacity to make mealtime an enjoyable experience and keep in mind that it may be a high point in the resident’s day.
(Aged Care Guide 2014; Reddy 2016; Health.vic 2016)
The first step is to ensure that the resident is sitting comfortably upright and is within easy reach of their meal.
Sit with the resident, making sure you are at eye level and ready to assist if needed. Cut up the meal in front of them once they have seen the meal as it is intended to look. Resist mixing the food together and await the resident’s instructions instead.
Ensure the spoon is at the resident’s eye level and give them enough time to open their mouth.
Demonstrate responsiveness to cues from the resident, such as knowing when to bring their plate closer toward them, when they are ready for the next mouthful or when they need a break.
Serve the resident as you would yourself, including different elements of the dish. Always have water nearby to aid food intake.
(Aged Care Guide 2014; Health.vic 2016)
After the Meal
Immediately after the meal is finished, check the appearance of the resident and their surroundings. For example, help remove any crumbs on their face or clothing and attend to any spills or messes (Reddy 2016).
Make an appropriate closing remark at the end of the meal - do not simply pack up and leave without saying anything (Health.vic 2016).
If you’ve noticed that the resident is not eating or drinking enough on a regular basis, communicate this to their family and relevant supervisors and document appropriately, such as in their care plan (Aged Care Guide 2014).
Before escalating the issue, try to find out if there’s a simpler reason why they’re not eating, for example, if the food isn’t to their liking or if they would rather eat at a different time of day (Eat Well Nutrition 2014).
Even subtle responses could be worth noting, for example, if there is a change in the amount of assistance they require, their behaviour shifts during mealtime or they display anger or frustration (Reddy 2016).
Imagine yourself in the resident’s place and approach meal assistance with sensitivity. Bear in mind that while a person may need significant help at mealtime, there is a difference between being helpful and undermining a person’s independence. Remember that your role is to share the mealtime experience with the resident and allow them to dine with dignity (Aged Care Guide 2014).