Assisting a patient to eat

Authors: V.Rednenko 

Editor: V.Rednenko 

Equipment for the practical skill:

• Simulated patient (patient manikin)
• Hospital bed with bedding
• Bed table
• Chair
• Devices for eating
  
  • plate
  • spoon
  • cup
  • straw
  • clothing protector
  • napkin
  • tray

Clinical situation:

Patient N. is in the neurological department with acute cerebrovascular accident, he is assigned to assisting for eat. The patient is bedridden.  Carry out the prescribed procedure.

Order of the skill performance:

Preparatory stage:

• Introduce yourself
• Identify patient
• Obtain informed consent to the procedure (if the patient's condition allows it)
  • Give all the information to the person about what the procedure involves, including the benefits and risks, whether there are reasonable alternative, and what will happen without this procedure
  • Explain what you are going to do.
  • Ask the patient to consent to procedure.
  • Explain to the patient how he can help.
• Make sure you have the necessary equipment and put it on the over-bed table (the chair next to the bed)
• Sanitize your hands, put on gloves
• Prepare the patient bed:
• Raise the bed to a comfortable working height.
• Make sure the wheels on the bed are locked

Main stage:

• Adjust equipment for body mechanics and safety: If the person will be getting out of bed to eat, lower the bed to the level specified in the person’s care plan. If the person will be staying in bed, raise the bed to a comfortable working height. Make sure the wheels on the bed are locked.
• Help the person prepare for the meal by assisting him with mouth care, toileting and hand washing. If the person will be going to the dining room to eat, help him with dressing and grooming as well.
• If the person will be eating in her room, prepare the room. Remove any source of unpleasant odors and make sure there is adequate lighting. If the person will be staying in bed to eat, change any soiled linens (or straighten clean linens).
• Position the person for eating.
  • If the person goes to the dining room: Help the person to the dining room. If a wheelchair is used to transport the person to the dining room, assist the person to move from the wheelchair to a regular dining chair at the table.
  • If the person stays in the room and eats in bed: Raise the head of the bed to Fowler’s position, and position the over-bed table at an appropriate height over the bed.
  • If the person stays in the room but gets out of bed to eat: Assist the person to transfer from the bed to the chair. Position the over-bed table at an appropriate height over the chair.
  • If the person would like to use a clothing protector, assist him in putting the clothing protector on.
• Obtain the person’s meal.
• Check the name and the diet noted on the card on the meal tray to ensure that everything is correct.
• Uncover the meal tray and help the person get ready to eat. Unwrap utensils and hand the napkin to the person. Assist the person with opening containers, cutting foods and seasoning the food or applying condiments as needed. If thickened liquids have been ordered for the person and you are allowed to use a thickening agent to thicken the liquids, prepare the liquids by adding the thickening agent in the specified amounts.
• If the person cannot readily identify the foods on the plate, tell her what foods and drinks have been served and where they are on the plate.
• Assist the person with eating as needed.
  • If the person can eat independently: Make sure the person has everything he needs (such as assistive devices for eating). Place the person’s method of calling for help within reach and tell him you will be back to check on him.
  • If the person needs your help to eat:
    • Sit down next to the person.
    • Help the person to have a few sips of liquid. Ask the person which liquid he would like to try first. If the person uses a straw, place the straw in his mouth so that he can suck and swallow the liquid as desired. If the person sucks too much liquid, you may need to pinch off the straw and pull it away so that he can swallow. If the person is drinking hot liquids through a straw, stir the liquid with the straw before offering it to him. This helps to distribute the heat evenly and prevent burns.
    • Ask the person which food he would like to try first. Fill a spoon only one-third full. Touch the spoon to the person’s lower lip and then to his tongue to let him know where the food is and when to open his mouth.

• • • Allow time between bites for the person to chew and swallow. Help the person to wipe his mouth with the napkin as needed.
  • After a few bites of food, offer the person a few sips of liquid. Continue in this way until the person tells you he has had enough to eat and drink.
• Check the person’s food and fl uid intake. If the person has not eaten one or more items that were served, offer to obtain substitute items that might be more appealing to the person.
• When the person has finished eating, note and write down the person’s food and fluid intake.
• Remove the tray and the clothing protector (if used).
• If the person ate in the dining room, assist the person back to his room.

• Assist the person with mouth care as needed.

Final stage:

• Ensure the person’s comfort and good body alignment.
• Adjust equipment for safety: Lower the bed to the level specified in the person’s care plan. Make sure the wheels on the bed are locked. Place the person’s method of calling for help within reach. Lower or raise the side rails according to the person’s care plan.
• Clean up your work area.
• Wash your hands.