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The Mealtime Partner Dining System is a unique product for many reasons and it is helpful to know a little about its development to understand how it came to be matchless in the world of powered dining equipment. It was the first powered dining product designed with a wide range of users in mind. Prior to its invention, dining aid products were generally made for a single individual and later put on the market for use by others, or developed to exploit a single technology that had become available (e.g., robotic arms). The problem with the single user and single technology approach to designing anything is that the product becomes specific to the needs and characteristics of one person or is constrained by the capabilities of the technology. Over the last 35 to 40 years a variety of technologies have been studied and devices constructed in an attempt to develop a device that can allow people that cannot self-feed, to do so. However, these devices have only been able to serve the needs of a small percentage of the people who need them.
The original concept for the Mealtime Partner Dining System began at The Arc of the United States (www.thearc.org) who identified the need for such a device for the large group of individuals for whom they advocate. In 1987, before starting work on developing the primary design concepts of the Assistive Dining Device (ADD), the predecessor to the Mealtime Partner, the Arc funded Southwest Research Institute (SwRI) in San Antonio, Texas, to conduct a thorough study to identify all products that aided people who were unable to feed themselves, that were commercially available, in development, or part of research projects. The search was conducted to find products throughout the world. Their final report included everything from utensils, to robots, and even monkey helpers. The study concluded that there was currently no equipment that was able to meet the criteria established by The Arc and recommended that a new device meeting their criteria be developed. The Assistive Dining Device (ADD) concept was developed with knowledge of all of the earlier powered feeding devices and was designed to overcome their shortcomings. The development of the requirements for the physical design was a collaborative effort of many experts and consumers. Its development began at The Arc of the United States and was culminated at Mealtime Partners, Inc. (Mealtime Partners) with the development of a field-test version of the Model 1 ADD.
Mealtime Partners continued the design evolution by developing a smaller, more compact, and more easily manufactured ADD, which has been named the Mealtime Partner. (It is also often referred to as, the Partner.) The Mealtime Partner was put through governmental regulatory testing. The Partner is currently the only powered dining device that has gone through and passed all of the U.S. and international compliance tests. (Based upon the test reports, a CB Certificate was applied for and received. The CB Certificate permits Mealtime Partners, Inc. to declare conformity with European and International Standards and place the CE Mark on the Mealtime Partner.) Also, the Mealtime Partner has been classified a Class I Medical Device by the FDA.
The complete list of design criteria that was developed to form the design concept for the Mealtime Partner was extensive, some of which are considered to be Mealtime Partners proprietary information. Some of the requirements were derived from obvious problems with the earlier devices and some came from consumer ideas about what they desired in a product. In this article we will identify a few of the more obvious criteria that had been neglected in earlier designs and that were addressed in the development of the Mealtime Partner Assistive Dining Device:
user access to the equipment
control of the amount of food on the spoon
keeping foods separated
speed at which the device moved
user control over the device operation
and most importantly, user safety
User access to the equipment. All prior devices developed, with the exception of a robotic arm named the Handy One (that is no longer on the market), required the user to sit at a table to use the equipment. For those who sit in a wheelchair at mealtimes this is limiting simply because if your wheelchair does not allow you to pull up closely enough to a table, you will be unable to use the equipment. This simple restriction excludes as many as 2/3 of the individuals who need the equipment to facilitate independent eating from using it. Even in 2012 the Mealtime Partner Dining System is the only equipment that allows user access without it being put on a table-top for use.
To address this problem, a selection of mounting methods was developed for the Mealtime Partner. It can be mounted on the Support Arm for individuals who sit in a wheelchair to eat and who have very limited range of movement. It also makes the Partner accessible to those who sit in powered wheelchairs that, because of its size, cannot be positioned very close to a table; or wheelchairs that have controls mounted in front of the wheelchair arm that prohibit the chair from getting close to a table. Also, for those who require a laptray on their wheelchair, the Support Arm allows the Mealtime Partner to reach the user despite the laptray. The Support Arm is attached to a table (or other secure object) with the Mealtime Partner Table Clamp.
Similarly, a Mounting Shaft can position the Mealtime Partner for use with wheelchairs. They are available in lengths of 2, 4, 6, 8, and 10-inches. They are quicker and easier to adjust and less expensive than the Support Arm, but are not continuously adjustable, being available only in discrete lengths. The Shafts are also attached to a table with the Mealtime Partner Table Clamp. Following the "safety first" policy employed in the overall design of the Mealtime Partner the shafts will allow the Mealtime Partner to rotate if it were accidentally struck, but will not rotate so freely as to move when simply touched by the user (as will the Support Arm).
Lastly, for those who can (and want to) sit at a table, additional versatility to adjust the device height is provided, by making 2, 4, and 6-inch legs available.
|Support Arm||Mounting Shaft||Legs|
Food pickup. The inventors of the earlier devices had never seriously considered food pickup. The view was that a spoon was used and whatever food it could scoop from a plate would be picked up and brought to the user’s mouth. No provision was made for too much food or an empty spoon, both of which occurs frequently. (Being presented an empty spoon has proven to be particularly frustrating to hungry eaters). The Mealtime Partner uses a unique “gravity feed” system with bowls that contour to the shape of the spoon to reliably pick up food and steep sides to allow gravity to pull remaining food back to the bottom of the bowl.
In summary, due to a thorough analysis of all earlier dining device research and device designs, and the development of extensive user requirements by many users and experts in related fields prior to beginning the physical design (and not being constrained to any specific technology), the Mealtime Partner turned out to be the best powered dining device ever built. The multiple positioning methods and methods for control make it the only dining system that is usable by the majority of people who are unable to feed themselves. It has reliable food pickup, and controls the amount of food presented to the user. It does not mix foods and is adjustable in the speed the food will be delivered. And, it is the safest powered dining device ever built. This is why, in 2012, the Mealtime Partner Dining System is a unique product that is still unrivaled in the world of powered dining equipment.
The remainder of this article (Part 2) will be in the May 2012 Newsletter and will describe how the Mealtime Partner is able to satisfy the remaining design requirements listed above: control of the amount of food on the spoon, keeping foods separated, speed at which the device moved, user control over the device operation, user safety, and other information that may be of interest.
|Did You Know? Did you know that many people are unable to drink through a straw simply because they bite down on it and crush it. They have the ability to suck through a straw but lack the jaw control to use a soft straw. To address this problem many people purchase reusable straws, aquarium tank tubing, or tubing from a hardware store. A better solution is crush proof oxygen tubing. This can be purchased on line or at a store that sells medical and oxygen supplies. The benefit of using this type of tubing is that it has small ridges inside the tube that hold the tube open, even if it is crushed. For those who bite down hard on a straw, a length of this tubing can allow them to bite as hard as they need without stopping the flow of liquid. Not only is this an easy solution to the problem of crushing a straw but it allows the tube to be cut to a custom length for each user. For more information about straws and drink please refer to our December 2009 Newsletter Topic: Using Straws for Safer Drinking.|
Gastroesophageal reflux disease (GERD), or acid reflux, is a condition that is a chronic problem for those affected by it. Common symptoms of GERD are heartburn (a burning feeling in the chest), a feeling of food being stuck behind your breast bone, nausea after eating a meal, a cough, a voice that is horse sounding or a sore throat. Symptoms can worsen at night when lying down. GERD is caused by stomach contents leaking back out of the stomach into the esophagus (the tube that carries food from the mouth to the stomach). Gastric or stomach acid, food and drink, and/or pepsin (a digestive enzyme that’s main function is to break down proteins that have been eaten) may leak out of the stomach. The impact of these substances on the lining of the esophagus can be harmful because they are caustic and the continuous back flow irritates the esophagus and can cause GERD.
Leaking is able to occur because the muscle fibers that form a ring at the base of the esophagus, called the lower esophageal sphincter (LES), do not close off the stomach completely from the esophagus. Therefore, leakage, or reflux can occur. Several factors can contributed to the occurrence of GERD including smoking, alcohol, drinking sodas, obesity, certain medicines, spicy food, eating big meals, eating prior to going to bed, eating too fast, etc.
GERD is one of the most common health problems that occur in adults in the United States. Also, it is not uncommon for infants to suffer from GERD. In babies it can be due to them having a poorly coordinated or under developed intestinal tract and they are otherwise healthy. However, some infants have GERD as a result of problems affecting their brain, nerves or muscles.
It is common for people with disabilities that prohibit them from feeding themselves to be affected by GERD. For those who have a congenital disability the cause of their GERD may relate to the basis of their disability. However, it can also be triggered by how they are being fed. This also applies to individuals who have an acquired disability. In many cases people who are fed are provided food too quickly, without time between bites to chew adequately and swallow. Therefore they swallow lumps of food that have not been chewed up into tiny pieces that will digest easily and can cause indigestion, which if occurs frequently can lead to GERD. Swallowing big lumps of food can also increase the risk of choking and/or aspiration. Additionally, many people who are fed are given too large a meal at one time, rather than smaller meals more frequently. This often is a result of limited time on the part of the care provider.
There are several ways of managing GERD. The first that is recommended is making lifestyle changes such as avoiding foods that cause problems, not eating for several hours before bed, not taking aspirins, etc. However, if lifestyle changes do not correct the problem there are several treatments that may be beneficial: medicine; surgery; or endoscopic treatments. There are three main groups of medicines used for treating GERD: antacids that neutralize the acid in the stomach; histamine type 2 receptor antagonists (H2RAs) that cause the stomach to make less acid; and, proton pump inhibitors (PPIs) that also cause the stomach to make less acid. PPIs are better at relieving heartburn and letting the esophagus heal than H2RAs.
For some people medicines do not control their reflux problems and surgery is a consideration. The surgery, called a fundoplication, takes the top part of the stomach and wraps it around the bottom of the esophagus and sews it in place. This reinforces the LES preventing reflux from occurring. This surgery is performed on children who have reflux problems that are severe enough to produce regular vomiting (in some cases several times a day) and for those who have erosion of the esophagus, or who are aspirating regularly.
The newest treatment for GERD is endoscopic treatment. It is not considered surgery as the treatment is conducted by putting an endoscope down the patient’s throat to perform the treatment. Because of the newness of this treatment there are not enough studies to know how well it works for the treatment of GERD.
For people who are unable to feed themselves, providing them a means to self feed such as a Mealtime Partner Dining System will often reduce or eliminate their GERD because it allows them to select the foods that they want to eat and control the pace and volume of food that they eat. For many individuals this is a simple solution to a chronic problem.
More information about GERD can be found in a report that reviewed 166 research studies on GERD. The report can be found at: www.effectivehealthcare.ahrq.gov/gerdupdate.cfm.
|The Mealtime Partner is so flexible it is almost like having a custom designed dining system. From multiple mounting options to adjustable timing, the Partner can adjust to meet the needs of everyone from small children to adults, regardless of their diverse eating needs. For more information about the Mealtime Partner Dining System, you can visit the Mealtime Partners website, and/or view our 4 minute video.|
|If you need help in choosing the dining system that is best for your needs you can email your questions to us at firstname.lastname@example.org, or call us at (800) 966-8607. We are always happy to provide information to help you make the best choices.|
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