Wednesday, July 4, 2012


   If your patient can’t come to the dinner table and must eat in bed from a tray, be sure to brighten up the tray with a pretty place mat or a flower in a small vase.  Bright colors help to cheer the patient and soft music can also soothe them and make mealtime more pleasant.
     If they don’t eat much at mealtime, provide some nutritious snacks such as fruit, cheese, raw vegetables, juices, or just bread and butter, to help supply needed nutrition.  Sometimes smaller meals are more suitable for a poor appetite.  Four or five small portions each day will be handled better than three large ones.  A large portion is overwhelming to a person who doesn’t feel well and it’s also hard to gauge how much they’ve eaten.  Most likely their doctor will want to know how much the patient eats, in case there needs to be supplemental feeding.  If you do need supplements, there are many canned supplements on the market.
     Remember that if the patient had a small appetite before their illness, you can’t expect them to have a large appetite now.  They may be accustomed to only a cup of coffee in the morning.  If you feed them a big breakfast, you will be wasting a lot of food.  You can try adding a little more each day until they eat a more balanced meal.  But it takes time...don’t hurry.
     If the patient cannot chew easily, be sure to cut their food into bite-sized pieces.  If the patient is low on energy, you may have to serve soft foods for awhile.  If you need to thicken everything for easy swallowing, use gelatin to thicken cold drinks and potato flakes for hot foods.
     Sometimes the patient has a problem swallowing, or dysphagia.  This condition can cause all sorts of eating problems.  There are two types of dysphagia.
     Paralytic dysphagia results from damage to the lower motor system originating in the brain stem.  The swallowing reflex may be diminished or absent and the muscles for swallowing paralyzed, which leads to the high risk of aspiration.  Aspiration refers to breathing in food and drink.  People that have difficulty swallowing are at high risk of aspiration and consequent choking.
     The other type of dysphagia is pseudobulbar dysphagia.  This is a result of damage to the intellectual centers of the brain and the upper motor systems of the brain.  In this condition, the swallowing reflex is not paralyzed, but the supporting muscles may be weak or uncoordinated, which also can lead to aspiration.
     If the patient can swallow liquids, there are supplements available that can increase their caloric intake.  Ask their doctor about specific supplements before you use them.  He may have other methods of treating the condition.  He might also suggest diet restrictions.
     If your patient needs to increase their fluid intake and calories, mix a can of supplement with fruit, ice cream, or yogurt, then blend it for a delicious milkshake.  You can substitute frozen cola, fruit ice, popsicles, or slushy drinks for different flavors.  But, whatever products and foods you use, clear them with their doctor first.
     Keep track of how much food is eaten and how much liquid the patient drinks.  The doctor will ask, so keep good records.
                                            Watch for a poor appetite.
                                            Join the patient at mealtimes.
                                            Keep an antacid on hand for heartburn.
                                            Serve a balanced diet.
                                            Watch for trouble swallowing
                                            Keep good records for the doctor.
                                            Serve nutritious snacks in between meals.
     Give someone a hug each day.  Personal contact makes us feel warm and comfortable.

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