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Self-Feeding for Older Adults

“80% of older adults have at least one chronic condition” (Neves et al., 2020). Increasing in age is associated with acquiring chronic health conditions such as: dementia, paralysis, or dysphagia (swallowing difficulty). These chronic conditions may impact the person's higher functioning skills as it relates to cognition, memory, orientation, language, and judgment, all of which are needed to be successful in day-to-day activities (Rehman et al., 2023; Boczko & Feightner, 2007). Aging can diminish the ability to complete daily tasks with ease. As one age, daily tasks such as toileting, eating, hygiene, and dressing become more difficult. The difficulty comes from the impairments of physical, cognitive, and sensory function (Boczko & Feightner, 2007). In addition, aging comes with alterations to the taste and smell sensations that affect an individual's appetite, diet, and oral intake (Christmas & Rogus-Pulia, 2019). These significant changes in one’s life can alter typical eating habits and routines. When routines or habits are forgotten, it can lead the person to undereat, overeat, or not be aware of their nutritional intake.


Eating is closely related to our culture, environment, role, education level, and economic status (Neves et al., 2020). Since self-feeding becomes increasingly difficult as a person ages, it is important that there is support from their family or peers (e.g., caregivers, therapists, physicians, nursing staff). Sagari et al. (2023) found that self-feeding ability is determined by the support the person has. As feeding occurs multiple times a day with food preparation and consideration of the person’s diet, this responsibility can become a burden for the person taking care of their spouse, patient, or peer. In order to decrease the need for others to feed their aging patient, spouse, or peer, it is important that education is enforced to continually work the cognition, memory, language, and orientation of the brain. Occupational therapists can help patients address these barriers and increase their ability to complete daily activities.


What Occupational Therapy can address (but not limited to):

  • Hand dominance

  • Range of motion strength

  • Coordination

  • Sitting balance

  • Safety awareness

  • Oral sensory skills

  • Motor planning

  • Problem solving

  • Memory

  • Posture

  • Provide feeding modifications

  • Meal preparation

  • Utensil use

  • Caregiver education


Tips for Increase Successful Eating For the Aging Population:

  • Provide reminders throughout the day and slowly backing off on the reminders

  • Re-teach mealtime behaviors until learned

  • Re-teach eating habits until learned

  • Create compensatory strategies

  • Create feeding modifications

  • Remove distractions (e.g., television, music)

  • Use bright color utensils/plate for individuals with decreased vision or depth perception

  • Use window shades or screens to reduce glare

  • Encourage oral hygiene (e.g., provide reminders to brush teeth)

  • Ensure proper positioning in chair for increase safety and ease when eating (e.g., feet flat on the floor, elbows at 90 degrees)

  • Create a food diary to track food intake


Examples of Assistive Feeding Devices:

  • Wonder-flo Cup

    • Helps drink in a semi-reclined position

    • Liquid only flows when the user is sucking

  • Nosey Cup

    • Useful for users with a reduced neck extension

    • No tilting of head necessary

    • Removed piece of cup to allow room for nose or glasses

  • Sure-Grip Utensils

    • Utensils that have a bulky handle

    • For users with a weak grasp

    • Utensils are comfortable for the hand

  • Sure-Grip Bendable Utensils

    • Useful for users with a decreased wrist range of motion

    • Utensils are comfortable for the hand

    • Utensils minimal wrist/hand motion

  • Weighted Utensils

    • Useful for users with limited hand control

    • Useful for users that have Parkinson’s disease with tremors

    • Utensil has a bulky handle for comfort

  • Coated Utensils

    • Provides protection for the teeth and lips

    • Useful for users that have mouth sensitivities (e.g., cold, hard surfaces)

    • Useful for users that have a strong bite refle

  • Plate with Inside Rim

    • Useful for users that have tremors or involuntary hand movements

    • Prevents the food from sliding off the plate

  • Partitioned Scoop Dish

    • 3 sectioned plate

    • Useful for users with a visual impairment

    • Useful for users with involuntary coordination


References

Boczko F, & Feightner K. (2007). Dysphagia in the older adult: the roles of speech-language

pathologists and occupational therapists. Topics in Geriatric Rehabilitation, 23(3),

220–227. https://doi.org/10.1097/01.tgr.0000284766.30549.06

Christmas, C., & Rogus, P. N. (2019). Swallowing Disorders in the Older Population. Journal of

the American Geriatrics Society, 67(12), 2643–2649. https://doi.org/10.1111/jgs.16137

Neves, F. J., Tomita, L. Y., Liu, A. S. L. W., Andreoni, S., & Ramos, L. R. (2020). Educational

interventions on nutrition among older adults: A systematic review and meta-analysis of

randomized clinical trials. Maturitas, 136, 13–21. https://doi.org/10.1016

/j.maturitas.2020.03.003

Rehman, S., Likupe, G., McFarland, A., & Watson, R. (2023). Evaluating a brief intervention for

mealtime difficulty on older adults with dementia. Nursing Open, 10(1), 182–194.

https://doi.org/10.1002/nop2.1293

Sagari, A., Tabira, T., Maruta, M., Tanaka, K., Iso, N., Okabe, T., Han, G., & Kawagoe, M.

(2023). Risk factors for nursing home admission among older adults: Analysis of basic

movements and activities of daily living. PLoS ONE, 17(1), 1–10. https://doi.org/10.1371

/journal.pone.0279312

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