Requiring assistance to eat daily meals puts clients in a vulnerable position. A great deal of tact and constant communication are needed from the staff providing this care.
There are steps you can take to make a client’s mealtime as dignified and as seamless as possible.
It’s estimated that 15% of clients receiving home care are malnourished (TAS DoH 2020).
One simple way to increase the likelihood of a client receiving the nutrition they need is to play an active role in their mealtime. In doing this, you are able to observe that:
The meal is properly cooked and prepared
The client is finishing the meals.
This article will outline methods of providing effective meal assistance in home care.
Reasons for Needing Assistance During Meal Time
Health complications that may affect a client’s ability to eat and drink independently include:
The level of assistance required by clients will vary.
The level of assistance required by clients will vary.
This can range from:
Supervision, prompting and encouragement
Setting up cutlery etc.
Cutting up meals
Full feeding assistance.
(Eat Well Nutrition 2014)
Before the Meal
It may seem obvious, but check that the meal is correct for the client.
Ensure the meal has been heated well and is the right consistency.
Check that tables and trays are set up to suit the client and appropriate utensils are available. Adjust these as necessary.
Ensure that the client has all the aids they require for mealtime, for example, dentures and glasses.
(Aged Care Guide 2014; Eat Well Nutrition 2014)
During the Meal
Communication
Talk to the client about the meal they’re about to eat. It is particularly important to explain what the food is when the meal has been puréed or modified to facilitate chewing/swallowing/digestion.
Ask the client if they would like a cloth or clothing protector, altered utensils or any other item that would make them feel more comfortable during mealtime.
Ask the client if there is something particular on the plate they would like to eat.
Always let the client know what you are doing and identify what the food is before serving it to them.
Make conversation with the resident if appropriate.
Do everything in your capacity to make mealtime an enjoyable experience and keep in mind that it may be a high point in the client’s day.
(Aged Care Guide 2014; Health.vic 2016)
Physical Assistance
The first step is to ensure that the client is sitting comfortably upright and is within easy reach of their meal.
Sit with the client, making sure you are at eye level and ready to assist if needed. Cut up the meal in front of them once they have seen the meal as it is intended to look. Resist mixing the food together and await the client’s instructions instead.
Ensure the spoon is at the client’s eye level and give them enough time to open their mouth.
Demonstrate responsiveness to cues from the client, such as knowing when to bring their plate closer toward them, when they are ready for the next mouthful or when they need a break.
Serve the client as you would yourself, including different elements of the dish. Always have water nearby to aid food intake.
(Aged Care Guide 2014; Health.vic 2016)
After the Meal
Immediately after the meal is finished, check the appearance of the client and their surroundings. For example, help remove any crumbs on their face or clothing and attend to any spills or messes.
Make an appropriate closing remark at the end of the meal - do not simply pack up and leave without saying anything (Health.vic 2016).
If you’ve noticed that the client is not eating or drinking enough on a regular basis, communicate this to their family and relevant supervisors and document appropriately, such as in their care plan (Aged Care Guide 2014).
Before escalating the issue, try to find out if there’s a simpler reason why they’re not eating, for example, if the food isn’t to their liking or if they would rather eat at a different time of day (Eat Well Nutrition 2014).
Even subtle responses could be worth noting, for example, if there is a change in the amount of assistance they require, their behaviour shifts during mealtime or they display anger or frustration.
Be Tactful
Imagine yourself in the client’s place and approach meal assistance with sensitivity. Bear in mind that while a person may need significant help at mealtime, there is a difference between being helpful and undermining a person’s independence.
Remember that your role is to share the mealtime experience with the client and allow them to dine with dignity (Aged Care Guide 2014).
A great deal of tact and constant communication is needed from the healthcare staff providing this care.
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