1 Module 11 The Eating Process Geriatric Aide Curriculum NC Division of Health Service Regulation

2 The Eating Process Objectives 1. Break down the eating process into its various steps. 2. Recognize common age associated changes that can affect the eating process. 3. Recognize the effects of selected diseases and health problems on nutrition and hydration.

3 The Eating Process Objectives 4. Relate person-centered care and the eating process. 5. Relate common cultural practices to the nutrition practices in various settings. 6. Describe different types of adaptive equipment that would assist a resident in the eating process.

4 The Eating Process Objectives 7. Recognize common eating problems of a resident who is cognitively impaired. 8. Demonstrate how to assist the resident who is cognitively impaired with eating.

5 The Eating Process Objectives 9. Recognize when a resident is experiencing swallowing problems. 10. Demonstrate how to assist the resident who is experiencing swallowing problems with eating. 11. Explain the role of the nurse aide in the resident’s eating process.

6 The Eating Process Before assisting a person with dining, the nurse aide needs to know the type and amount of assistance the person needs. Eating, drinking and digesting are complicated processes. Eating and drinking involve skillful coordination of thinking and doing.

7 Eating and Drinking Sensory skills and internal awareness Thinking skills Pain management Gross motor skills (large movements) Fine motor hand skills (small movements)

8 Eating and Drinking (continued) Oral motor control Intact mouth structures GI tract function Kidney/bladder function Psychological well- being

9 The Eating Process

10 The Eating Process and Aging Sensory skills and internal awareness Thinking skills Pain management Gross motor skills (large movements) Fine motor hand skills (small movements)

11 The Eating Process and Aging (continued) Oral motor control Intact mouth structures GI tract function Kidney/bladder function

12 Effects of Disease on Eating Sensory skills and internal awareness Thinking skills Pain management Gross motor skills (large movements) Fine motor hand skills (small movements) Oral motor control

13 Effects of Disease on Eating (continued) Intact mouth structures GI tract function Kidney/bladder function Psychological well-being Increased nutritional needs Medications

14 Individual Preferences

15 Person-centered Eating Respond to each person’s spirit. All people are entitled to make their own decisions about their lives. Speak up for the personal needs and desires of each person. Appreciate and honor each person’s lifelong pattern by responding to each person’s preferences and needs.

16 Culture and Nutrition Culture has a strong influence on individual preferences

17 Adaptive Equipment Improves ability and independence of eating and drinking. Eating devices include dishes, utensils, and non-slip materials. Nurse aides report the eating problems to the team to be addressed. Nurse aides need to know what equipment is available and how to use it.

18 Assisting the Cognitively Impaired with Eating 3 types of helping –Visual or sight related cues: what the person SEES –Auditory or verbal cues: what the person HEARS –Tactile or touch cues: what the person FEELS

19 Which Type Of Help To Use Think about the person’s abilities and limitations. Then think about the problem, what the difficulty is. Next match the type of help to the situation (types of help: seeing, hearing, touching).

20 Common Problems And Ways To Help Task is too complicated -break down the task Trouble with initiation - help get started Too much going on - reduce distractions Not eating enough - Monitor for finishing too soon Share what worked with the team

21 Swallowing Some common conditions that lead to swallowing problems are: –Stroke, Parkinson’s disease, Alzheimer’s disease can lead to trouble coordinating muscles –Obstructive swallowing problems with cancer, stricture (narrowing of esophagus) can lead to a blockage of the esophagus

22 Assisting Individuals with Swallowing Problems  Using good helping skills can help prevent pneumonia. Observe for signs of problems with swallowing Report changes in swallowing to the nurse or healthcare team Provide care that’s helpful to each individual

23 Role of Nurse Aide in Assisting the Cognitively Impaired Individual with Eating Discover how the individual responds to help Share with co-workers and supervisor what helped and what did not help Use the type of help that works for the individual

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