Introduction: Independent eating is something that most cultures consider an important activity of daily living. It is not always fully understood that people who are unable to feed themselves can benefit greatly if they can gain control over eating. The activity of eating influences many of the known psychological benefits associated with greater independence, such as improved dignity and self-esteem and reduced feelings of being a burden to their caregiver (Gustafsson)1. Hermann, et al.2, supports a similar view stating that “eating activity influences many aspects of our overall medical, physical, and social well being”. The ability of food self-selection and the capacity to set ones own pace in eating can potentially ameliorate some of the undernourishment and/or gastric problems, as well as some of the risks of being fed, that often occur for people who are fed.
We all start out our lives being fed. During the first year or two of life most people develop the skills necessary to feed themselves. Eating becomes an automatic activity that is given little or no conscious thought. However, some people are unable to develop the skills needed to self-feed due to a variety of causes and being fed is continued out of necessity. This group will potentially be dependent upon another person for all of their nutritional needs, and in many cases for hydration, for their entire life.
An additional group of people, who have been independent eaters, lose the ability to self-feed due to illness or injury and become dependent upon another person to feed them and, often, to also provide them with a drink. To facilitate mealtime independence it must be understood that for those who have never experienced independence in eating, the perception of self-feeding is different from those people who have had self-feeding experience. Therefore, teaching someone, who lacks familiarity with self-feeding, to feed them self must be approached with that understanding. If food has always been placed in their mouth without them being required to participate in removing the food from the utensil, they will not understand the concept and will have to learn it before they will be able to gain any degree of independence. Read more on this topic ...
The Mealtime Partner Dining Device was designed with safety as the highest priority and using it complies with all of the safety and health issues described above. With the Mealtime Partner, the user controls when the food is taken from the spoon so the eating process is fully coordinated. This reduces the risk of choking or aspiration. Also, the Mealtime Partner is infinitely patient and will never hurry the user. The user has adequate time to enjoy the meal and the risk of undernutrition and acid reflux, which can both lead to other health problems, are greatly reduced.
A MtP Tip: When using a Straw to drink, using lip balm can aid in sealing around the straw, making suction easier and requiring less effort. (Vaseline Petroleum Jelly works slightly better than Chap Stick, but both help.)
As mentioned in another article, there are approximately 40,000 deaths in the U.S. each year due to aspiration pneumonia and people who require feeding are more vulnerable to aspiration (which can lead to aspiration pneumonia) than people who self-feed. Ensuring a good chin tuck while eating or drinking can reduce the risk of aspiration and is high on the Mealtime Partners (MtP) list of good practices whether being fed by another person or being aided by an assistive device.
Even though there is no precise anatomical definition of “chin-tuck”, in general, a chin tuck is a head position that places the chin slightly downward towards the individual’s chest. Regardless of the exact execution of the chin tuck, it is a position that can improve the probability of taking a bite of food, chewing it, and swallowing it safely. When the head is slightly forward and down, the windpipe is in a protective position; food or liquid is less likely to enter the airway than if the head is upright. When food enters the airway, the result is choking, or, if the individual does not have an adequate gag reflex or cough, aspiration. (Aspiration occurs when food or liquid is drawn into the lungs instead of going down the esophagus into the stomach. Aspiration frequently results in an infection in the lungs known as aspiration pneumonia.)
The greatest difference in interpretation of how to implement a chin tuck appears to lie in the alignment of the head over the spine and the level of the chin relative to the chest. In a practical sense, having the head aligned over the spine with the chin tilted downward allows the muscles to work at their best to chew and swallow. A simple experiment to understand this phenomenon can be conducted by taking a drink with your head in a chin tuck, and repeating the process with your head fully extended upward. Note how the muscles of the mouth and throat feel in the different positions. Also, note how the muscles are elongated and feel tighter when the head is raised. Basically, more demand is placed on the muscles when the head is raised and controlling swallowing is more difficult. This is particularly significant if the person already has swallowing difficulties. Read more on this topic ...
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