One thing is that with feeding assistance, it was reported that if they're fed too rapidly and the food is provided in an uncontrolled manner so that the person is not able to actually swallow the food prior to the presentation of the next intake, that it has no effect on aspiration.

We were unable to reduce aspiration through uncontrolled or rapid feeding. So what this requires is quite targeted feeding and we also require training with those that do feed.

Now this can often be difficult in the aged care setting or in a setting where time constraints require that numerous people are fed in a short period of time. But it needs to be remembered that with this rapid uncontrolled feeding that we aren't reducing aspiration in these older adults.

One of the key issues is to train staff to ensure that they're feeding in a controlled manner that we minimise distractions, almost like when we're feeding our children, we try to minimise the distractions so that they're less likely to choke on the food. Also, it's reported that certain utensils can be prepared differently so that the person's able to consume the food more safely.

It is noted that people can actually rehabilitate their swallowing. So in the earlier stages, people can actually learn to retrain their swallowing reflex so that they can actually improve their ability to consume foods. But this part we won't be covering in this presentation.

As an example, it's reported in aged care that approximately six minutes is provided per person to assist with eating. However, the data is actually indicating that they require 30 or more minutes per person to ensure that their nutritional intake is adequate.

Some work was done where they did a 24-week crossover study in that half the residents are provided the additional assistance and then for the second half of the study they're actually consuming foods in their normal manner. They picked residents that were at risk of malnutrition and they provided assistance with eating meals and snacks.

What was noted is that energy increased by approximately 300 calories per day And during this phase of assistance with their eating, weight was maintained or increased. However, during the phase of non-assistance, non-assistance, so during the control period, they actually lost weight. So it demonstrates we can actually assist these older adults with their food intake simply by assisting with their feeding.

What we do know is that they required 42 minutes of assistance to consume a meal relative to the five minutes they're currently receiving. And also 13 minutes to assist with the consumption of snacks compared to the one minute that they're currently receiving. In the aged care setting or even in the hospital setting, the presence of volunteers or relatives assisting with the feeding can have a major impact on the intake of that older adult.