Therapists, adaptations help seniors with eating
Peas on the floor, meat bits on the place mat or pieces of pasta falling off the table’s edge — that’s common when a child is learning to eat.
But when it happens for an aging adult, that’s a problem. Occupational therapists and registered dietitians are among the health professionals who help find solutions.
“We’re trained to make someone as independent as possible,” said Celeste Livengood, the occupational therapist at Fair Winds Manor, 126 Iron Bridge Road, Sarver.
“The first thing that I do when assessing self-feeding abilities is I look at their positioning,” said Laura Pierce, a St. Barnabas Health System occupational therapist.
“Positioning and table height, if we don’t have those two things working for someone, the rest of it is a big struggle,” Pierce said.
Livengood said the elderly may lean to one side and need adjustment to sit upright. Wheelchair foot rests may block them from being close enough to the table. Bulky power chairs may not be the right height for the table.
“We always teach to reduce the stimulation in the environment especially with a cognitively impaired person — clutter at the table, television, too many people in the room, too many utensils,” Pierce said. “They get so confused and distracted and they become frustrated and they just don’t eat.”
If adaptive equipment is the solution, Pierce said, “We want to try to make it as simple as we can.”
Just What the Doctor Ordered in Lyndora sells such adaptive equipment.
Cate Graham, the store owner, said a bowl or plate with a suction cup on the bottom can keep it in place when someone is capturing food with a utensil. A high edge on a plate or a plate guard keeps food on the plate and is something to push food against to get the food on a utensil.
Some utensils have textured and thicker handles. Graham said the eating end of some utensils is flexible enough to bend to make eating easier.
She said an individual with neurological issues that cause tremors might use weighted utensils. The weight slows the tremors so food stays on the fork or spoon.
Some of the store’s dinnerware is red. Graham said this can help those with vision issues because food stands out from the contrasting red background.
Livengood said some people do not have enough wrist rotation to tilt a cup to allow sipping. Cups designed with one scooped out side can overcome that.
Natalie Kolish, a registered dietitian at Concordia Lutheran Services in Jefferson Township, said, “I see a lot of people who come in here and they’ve never even heard of adaptive equipment. There’s a lot more out there than people realize.”
Bernie Faull, 98, lives at The Arbors of Valencia. Ten years ago, she had a stroke and now cannot use her left side. She is right handed, but it’s difficult to do everything with one hand.
“My fingers are stiff,” said Faull, who has arthritis in her right hand.
She adapted well to using a wide-handled spoon and a plate guard and continues to feed herself. The plate guard keeps food from sliding off the plate. She can reach through the open side without having to reach over the lip of the guard.
Faull said the bigger handle of the spoon is easier to hold and was easier to adjust to than the plate guard.
“I have to hold (the spoon) in a funny way,” Faull said. “It’s clumsy, but it works.”
“She had a lot of pain in her thumb from her arthritis and the spoon was just wide enough to get rid of that pain,” Pierce said.
Even if it’s hard, messy or slow, Pierce said independent eating is important for self-esteem, self-purpose and confidence.
“It’s a matter of dignity as well as safety,” said Livengood. “People are less likely to choke on their food if they are feeding themselves.”
Kolish said people sometimes won’t eat with others because they don’t want tablemates to see them spilling food on themselves.
“If they can feed themselves, they are a lot more likely to eat more from their plate,” Kolish said.
With aging, the sense of taste may decline. Kolish said if that’s combined with problems getting the food to their mouths, the person doesn’t enjoy their food.
“They eat less or some people have a tendency to skip meals,” Kolish said.
Pierce said anyone noticing a feeding problem can ask a physician for a referral to get help.
Erica Montgomery, who helps customers at Just What the Doctor Ordered, said some people have trouble admitting that they need something special to help them eat.
She said, “You have to listen to what they have to say.”
“And what they don’t say,” Graham said.
Reluctance also can be due to finances.
Graham said prices reflect the expensive engineering behind adaptive technology and the small market for the products. Insurance coverage varies for the adaptive items, and Graham said some customers pay using money from health savings accounts.
Pierce said others can allow someone the right to be slow and the right to struggle a little bit with eating.
“Sometimes you have to walk away from them and not watch,” Pierce said. “Feeding is one of the only things they can do for themselves.”
“That’s one of the first things we learn to do for ourselves and we want to keep that intact as long as we can,” Livengood said.