MODULE 1: METHODOLOGY AND TOOLS DEVELOPMENT FOR ADULT EDUCATORS

Before feeding, it is important to know the needs of the person and to prepare a good environment to mealtime (adapted equipment, volume, thickeners, type of texture, food temperature...).

Maintain personal hygiene by washing hands with soap and water before and after meals.

Feed meals when the person is alert and attentive; check it before starting the meal and until the end of the process. If he feels drowsy or inattentive, techniques will be done to stimulate his attention (touches on the cheeks or questions to assess his attention). If you do not manage to reach a state of adequate attention, reserve the dose for another time.

Proper positioning of the person is essential during meals. Assist him/her to sit in an upright position before feeding. If necessary, put pillows or other prop behind his back for comfort and support.

Describe what food is on the plate before mealtime

Keep calm and confident attitude during mealtime

Encourage the autonomy of each patient whenever possible.

Provide mealtime assistance when necessary

Autonomous people: supervision throughout the feeding process and support at specific times.

Dependents: supervision and support throughout the meal.

To help feed, the caregiver must position himself at the same level as the patient, normally seated nearby to one side or in front of him/her to avoid hyperextension of the neck. Avoid positions standing, behind or away.

The caregiver should give the food with his dominant arm and from the bottom up, so that the person does not raise the head.

Check the volume of the food and drink provided. Food should be lifted to the mouth in small quantities.

Clear and easy-to-understand indications about the feeding process may also be needed. This may mean giving very specific directions such as “open your mouth”, “chew”, “swallow”

If there is no response to open the mouth, visual cues can help to initiate the process of eating. This might include the caregiver opening his/her mouth or making a slight pressure on the lower lip to stimulate the opening of the mouth

If the person keeps the food in the mouth for a long time, gently rub the spoon on the lower lip to encourage mouth opening.

While person is focused on eating, there should be no distractions. Discourage conversation when there is food in the mouth.

Make sure all the food and liquid is swallowed before feeding the next bite.

Before offering sips of fluid check the mouth to make sure there is no food remaining, especially in the cavities of the cheek or on the tongue.

Never hit the teeth with utensils whilst eating.

If bite reflex occurs while the utensil is on the mouth, wait until it stops and do not force or pull the utensil to take out it.

Alternate small bites and sips. Feed the person patiently, with a slow rate of feeding.

It is vital to know signs of eating problems or risk situations that may occur during feeding and how to deal with it.

Provide a serviette or a bib during the meal and wipe the person’s mouth as needed to keep hygiene and maintain dignity.

At the end of each meal, ensure proper oral hygiene.