Meal assists, tips, tricks and howto's.

[Levin]

I was inspired by the recent bed baths thread in Gen-nurs, and decided to start this one.

Meal assistance (aka "feeds" before the language police)

We all know (I hope) the basic stuff like watching for pooling, and sitting up forward to minimise the risk of it going down the Trachea. (i.e the science component)

I'm sure people have learnt lots of tips and tricks and things to watch out for over the years. (i.e. the art component).

Regards,

Levin

[shoreh2000]

i love what all of you have written. you guys have some great suggestions. lemon ice....wow...what a wonderful idea. my mouth is watering already. fish shakes :barf01: augh!!....but it worked...ha?

as an ex-surveyor the department will look to see what the facility has done to bring the resident back to their prior level. if you have to give a resident ice cream before he/she eats the meals, do that, but please care plan it and let everyone know about this plan because the regulations says so.

[Hunter's Mom]

that is so true.............you have mastered the art of feeding in geriatrics

[sissyboo]

Sometimes putting things into cups and allowing pt to drink them helps. If that doesn't work try adding ice and/or sweetener. Sometimes that makes a big difference!

[CapeCodMermaid, RN]

I might be wrong about this but I was under the impression that it was concidered "in bad taste" to mix an elderly persons food in stuff you normally wouldnt mix it in. (ie. choclate and meat) I've worked in a nursing home off and on and the rules have always been if you were caught you were written up for it. but it could be just one of thoes things where it is a facilities call.

If the resident LIKES his or her food that way, it's fine. Just make sure it's care planned. We had a surveyor get all upset because she saw one of the patients pour her orange juice into her oatmeal. She asked me why we allowed our residents to play with their food. I suggested she ask the resident why she did what she did. The resident said "Dearie, I am 93 years old and I have been eating my oatmeal with orange juice since I was old enough to chew!"

[weirdRN, RN]

I know this sounds totally disgusting but we had a little frail lady that would only eat meat, veges, etc, if it was drowned in chocolate sauce!

Yeck there goes my love for chocolate

[withasmilelpn]

Maybe the surveyers should read this site. I have so much paperwork to do already. Sometimes it is whatever works at the moment. If it is an everyday thing- sure careplan it. (I hate careplans! Aren't they just common sense?)

[Speechie]

i just love you guys!!! i am the speech therapist for a 224 bed LTC and i've recommended most of the things you've suggested at one time or another!

another one for the list... if you have a resident with hemiparesis, try assisting him or her from the WEAK side. that way, when she turns her head to look at you or receive her spoonful, she's spreading out and using her STRONG SIDE muscles and shortening her weak side muscles. This, especially when paired with a chin tuck, can keep residents off thickened liquids and eating and drinking more normal textures, and you don't have to keep verbally cueing "turn your head to the Left, Mrs. X". She will naturally look to the side where you are, to stay engaged with your sparkling self :).

one of the best parts of my day is going to the dining room and helping pass trays and assisting residents to eat. i get to be around the nurses and nursing assistants!

speechie :)

[weirdRN, RN]

Maybe the surveyers should read this site. I have so much paperwork to do already. Sometimes it is whatever works at the moment. If it is an everyday thing- sure careplan it. (I hate careplans! Aren't they just common sense?)

If it is truly common sense then everyone would automatically do it with out being prompted. However, some of the things that nurses do are not thought of by the lay person, thus the need for the careplan. Careplans at SNF's and LTC are not that hard to write, especially when you have a team of people to write them and all of the hundreds of careplanning books and programs to use. It's not like in school where you have to write out every little thing and explain the why behind it.

[CapeCodMermaid, RN]

If it is truly common sense then everyone would automatically do it with out being prompted. However, some of the things that nurses do are not thought of by the lay person, thus the need for the careplan. Careplans at SNF's and LTC are not that hard to write, especially when you have a team of people to write them and all of the hundreds of careplanning books and programs to use. It's not like in school where you have to write out every little thing and explain the why behind it.

Hmmmm...LAY people aren't giving the care...nurses and aides are. We don't have a 'team'...we have one or two people who actually write the care plans. We are joint commissioned and therefore have to have our care plans follow their guidelines which are different from corporate's view which are different from the surveyors view. Most care plans are a huge waste of time and paper. The ones the count are the CNA care cards. Most of the information you need is on one page --diet,amount of assist needed,size brief the resident wears if any,behavior plans, and even what activites they like.

[withasmilelpn]

Hmmmm...LAY people aren't giving the care...nurses and aides are. We don't have a 'team'...we have one or two people who actually write the care plans. We are joint commissioned and therefore have to have our care plans follow their guidelines which are different from corporate's view which are different from the surveyors view. Most care plans are a huge waste of time and paper. The ones the count are the CNA care cards. Most of the information you need is on one page --diet,amount of assist needed,size brief the resident wears if any,behavior plans, and even what activites they like.

Exactly! Careplans are awkward, repetitive, time consuming (despite LTC, SNF being easier than school), noone has time to read them, and they frequently are not updated anyway. Give me those 20 sheets of paper and I'll boil it down into one truly helpful one that sums it all up- like the cna's care cards! Thanks, CapeCod!

[withasmilelpn]

Sorry, a little distracted by the careplans comment earliar. ( As I said, I hate them!) But truly, thanks for all the really helpful tricks and tips everybody!