“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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