1. Feeding Assistance Program

2. First off.... Thanks for volunteering!

3. Presentation Outline 3 sections; Swallowing Swallowing Feeding assistance Feeding assistance Oral care Oral care

4. Swallowing Swallowing (deglutition) Swallowing problems (dysphagia)

5. Swallowing 3 stages involved in swallowing; Oral stage Oral stage Pharyngeal stage Pharyngeal stage Esophageal stage Esophageal stage

6. Oral stage

7. Pharyngeal stage

8. Esophageal stage

9. Why are we concerned about swallowing? Aspiration Aspiration Choking (airway blockage) Choking (airway blockage) Malnutrition Malnutrition Dehydration Dehydration

10. What to watch for when screening for dysphagia. Coughing when eating Coughing when eating ‘Wet’ vocalizations or respiration ‘Wet’ vocalizations or respiration Throat clearing Throat clearing

11. So, what can you do to help? Feeding assistance

12. The goal of assistance Maintain adequate nutrition and hydration. Maintain adequate nutrition and hydration. This is essential for fighting infection, recovering from illness, stopping skin breakdown, and helping to reduce confusion This is essential for fighting infection, recovering from illness, stopping skin breakdown, and helping to reduce confusion Watch for signs of aspiration! Watch for signs of aspiration! Companion Companion

13. Different types of assistance Companion/encourage Companion/encourage Assistance with setup Assistance with setup Partial assistance Partial assistance Full, one-on-one feeding assistance Full, one-on-one feeding assistance

14. For some, helping with setup and being a companion is enough Wash your hands Wash your hands Remove wrapping Remove wrapping Open cartons Open cartons Open and place straws Open and place straws Remember infection control Remember infection control Butter bread Butter bread Dice foods Dice foods

15. Others will need partial assistance... You may need to help with the menu You may need to help with the menu Wash your hands Wash your hands Setup the environment Setup the environment Make sure the meal is appropriate Make sure the meal is appropriate Glasses on and hearing aids in Glasses on and hearing aids in Remember, eating is social! Remember, eating is social! Sit at eye level and off to one side Sit at eye level and off to one side

16. Table at the right level Table at the right level Food in front and reachable Food in front and reachable Orient them to the location of items Orient them to the location of items Think of a clock Think of a clock Sometimes special feeding aids Sometimes special feeding aids Oxygen mask? Oxygen mask? Dentures Dentures Upright at 90 degrees Upright at 90 degrees Call bell Call bell

17. Others will need one-on- one feeding... These patients will be fed by hospital staff These patients will be fed by hospital staff Special needs that require 1-on-1 help Special needs that require 1-on-1 help We control all aspects of the meal We control all aspects of the meal Generally very serious risks associated with feeding and/or significant nutritional risks Generally very serious risks associated with feeding and/or significant nutritional risks

18. What do our diets look like.... taste like? Food can be pureed, minced, chopped, or regular. Liquids can be very thick, thick, or thin (regular)

19. Oral care Another area where you can help make a HUGE difference Another area where you can help make a HUGE difference Many patients don’t even have a toothbrush/toothpaste in the hospital. Many patients don’t even have a toothbrush/toothpaste in the hospital. One study found that almost 90 percent of nursing home residents with pneumonia got pneumonia from aspirating bacteria from poor oral care. One study found that almost 90 percent of nursing home residents with pneumonia got pneumonia from aspirating bacteria from poor oral care.

20. After the meal.... Encourage oral care after all meals. Encourage oral care after all meals. Especially in the evening Especially in the evening Studies show that if you do it at all, do it in the evening. Studies show that if you do it at all, do it in the evening. You can help with setup of the brush, paste, mouthwash. You can help with setup of the brush, paste, mouthwash. Check to see if we have special products there for them. Check to see if we have special products there for them. You may need to put the paste on. You may need to put the paste on.