Meal Assistance in Aged Care

Requiring assistance to eat daily meals puts residents in a vulnerable position. A great deal of tact and constant communication is 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 is rife in older adults in residential aged care (Leading Nutrition 2019). The reasons for this are multiple and varied, a wave of recent media reports have highlighted the poor standard of food served in Australian aged care facilities (Blumer 2018; Aged Care Guide 2018).

Another factor to consider is that older people have weakened immune systems and may have a heightened fear of food poisoning or food complications, therefore being 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 a) the meal is properly cooked and prepared and b) that the resident is finishing the meals.

This article will outline methods to provide effective meal assistance in aged care facilities.

Meal assistance relates to Standard 4 of the Aged Care Quality Standards: Services and Supports for Daily Living.

Reasons for Needing Assistance During Meal Time

Health complications that may affect a resident’s ability to eat and drink independently include:

• Dementia or impaired cognition;
• Weakness in hands or fingers due to joint pain (e.g. arthritis);
• Poor or restricted vision;
• Swallowing difficulties;
• Weakness or fatigue;
• Other physical or cognitive impediments.

(Eat Well Nutrition 2014)

Types of Assistance

The level of assistance required by clients will vary.

This can range from:

1. Simply requiring supervision, prompting and encouragement;
2. Setting up;
3. Cutting up; and
4. Full feeding assistance.

(Eat Well Nutrition 2014)

Before the Meal

1. It may seem obvious, but check that the meal is correct for the resident.
2. Make sure that it has been heated well and that it is the right consistency.
3. Check that tables and trays are set up to suit the resident and appropriate utensils are available and adjust these as necessary (Aged Care Guide 2014).
4. Ensure that the resident has all the aids they require for mealtime; for example dentures and glasses (Eat Well Nutrition 2014).

During the Meal

Communication

1. 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 (Aged Care Guide 2014).
2. 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 (Aged Care Guide 2014; Care Academy 2016).
3. Refrain from talking to other people while you are assisting with mealtime. Do everything in your capacity to make mealtime an enjoyable experience for the resident, keep in mind it may be a high point in their day (Aged Care Guide 2014).

Physical Assistance

1. The first step is to ensure that the resident is sitting comfortably upright and is within easy reach of their meal.
2. 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 (Aged Care Guide 2014).
3. 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 (Aged Care Guide 2014).
4. Serve the resident as you would yourself, including different elements of the dish. Always have water nearby to aid food intake.

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 (Care Academy 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 or if their behaviour shifts during mealtime and they display anger or frustration (Care Academy 2016).

Be Tactful

Imagine yourself in their 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.

Additional Resources

• Aged Care Quality Standards: https://www.agedcarequality.gov.au/providers/standards.
• Guidance and Resources for Providers to Support Aged Care Quality Standards: https://www.agedcarequality.gov.au/sites/...Aged%20Care%20Quality%20Standards.pdf.

References

• Aged Care Guide, Dignity in the Dining Room, Aged Care Guide, viewed 30 August 2019, https://www.agedcareguide.com.au/talking-aged-care/dignity-in-the-dining-room.
• Aged Care Guide, Quality of Food in Aged Care up for Discussion Again, Aged Care Guide, viewed 30 August 2019, https://www.agedcareguide.com.au/talking-aged-care/quality-of-food-in-aged-care-up-for-discussion-again.
• Blumer, C 2018, ‘Would You Eat This? The Real Food Inside Aged Care Facilities in Australia’, ABC Investigations, viewed 30 August 2019, https://www.abc.net.au/news/2018-09-17/food-in-aged-care/10212880
• Eat Well Nutrition 2014, Educational Video 4: Feeding Assistance, Eat Well Nutrition, online video, viewed 30 August 2019, https://www.eatwellnutrition.com.au/2014/09/10/educational-video-4-feeding-assistance/.
• Leading Nutrition 2019, Creating A Good Meal Time For Residents With Dementia- Aged Care Case Study, Leading Nutrition, viewed 30 August 2019, https://www.leadingnutrition.com.au/meal-time-strategies-for-dementia-care/.
• Reddy, M 2016, ‘How to Assist Adults with Eating and Drinking’, Care Academy, viewed 30 August 2019, https://blog.careacademy.com/personal-care-eating-drinking.

(Answers: a, d, c.)