Tools and Techniques to Help Seniors Achieve Independence in Eating

There are many medical conditions that can lead to difficulty with the ability to feed oneself. Often family caregivers find they have to step in and do much of the feeding when their senior loved one is incapable of feeding themselves due to their disease.

Of course we just have to help them. They can’t not eat.

If we think it’s tough on us, what about our senior loved one? After all, who wants to be fed if there is any possible way they can do at least some of the feeding themselves?

Let’s take a look at conditions that can cause self-feeding difficulties and then what we can do to help them.

Ways Feeding Impairments Can Happen

There are many diseases or traumas that result in a person being unable to feed themselves. At some point when the disease is progressive, they will not be able to do this themselves even with special devices or strategies but until then, they should be accommodated to stay as independent as possible.

Here are some reasons why adults can lose their feeding skills:

• Dementia. Because Alzheimer’s and other many types of dementia have progressive, neurological changes, self-feeding is one of the skills that will be lost as the disease advances. It is not just the loss of concentration but also the loss of awareness of utensils and the ability to get the food into their mouths without copious spillage.

• Stroke. Depending on the severity or location of a stroke and the amount of functional recovery, someone affected by stroke can have lifelong difficulty feeding themselves.

• Parkinson’s Disease. Similarly to dementia, Parkinson’s is a progressive neurological disease. A person with Parkinson’s usually has difficulty with motor control, tremors and stiffening of muscles, which can make it difficult to feed themselves.

• Vision Impairment. Having difficulty with vision whether it is low vision or blindness will make it difficult to locate food on a plate and feed themselves.

• Arthritis. Pain in the joints of the hand and fingers can negatively impact the ability and desire to manipulate utensils to self-feed.

• Spinal Cord Injury, TBI, Amyotrophic Lateral Sclerosis (ALS), Muscular Dystrophy, Epilepsy, Cerebal palsy, Corticobasal Degeneration (CBD), Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA). Each of these diseases and others can impair a person’s ability to hold utensils and maintain proper body position in order to feed themselves.

Overcoming Feeding Difficulty

If your senior loved one is having trouble feeding themself, it is a good idea to seek an evaluation by an Occupational Therapist (OT). This type of therapist is skilled in assessing individual strengths and weaknesses and recommending appropriate devices or compensatory strategies that will make feeding more successful. Talk to your senior’s doctor about a referral.

Here are some strategies that can work for your senior loved one.

1. Devices, known as adaptive feeding devices. There are a variety of different types of utensils, bowls, cutting knives, straws, and other things that can be used to overcome specific issues. Here is where the OT can direct you to what will work best.

Weighted utensils or weights on wrists can help stabilize tremors.

Scooped plates will help get the food onto the utensil. Some have suction bottoms to help keep the plate in place.

Divided or sectioned plates can also help with pushing food onto the utensil.

Curved utensils, scooped plates, plateguards, non-skid mats under the plate can all help assist getting the food into the mouth when the arms don’t do what they are told.

Long straws allow someone unable to tuck their chin to reach a drink.

Cups with lids prevent spillage when picked up fast or shaken. A travel mug is good for this.

Cups with handles to allow easy pick up if hands can’t grasp.

Cups with cut outs, called nosy cup, allows drinking without spilling when head tilt a problem.

Rocker knives allow a person to cut their own foods.

Easy grip tubes that fit over household utensils make grip softer for stiff fingers.

Builtup utensils have wide handles when grasping is painful or difficult.

2. Get their focus. When a senior loved one has dementia they can easily become distracted. One of the strategies that works well is to decrease meal time distractions. Lower the noise, position at the table with few visual distractions, such as TV or birds outside, and avoid patterned tablecloths. Use colored plates, cups and utensil. Use a special placemat that gives them a visual field. Serve food items in small bowls instead of on a plate to further focus them to the task at hand.
3. Make them comfortable. Anyone who has difficulty with motor control or even mental focus needs to have a chair that is helps them achieve the correct position. The chair should keep them at 90 degrees, have arms, and positioning devices recommended by the OT to keep their upper body upright. Make sure the table is at the right height. If you allow them to eat in the living room on the soft couch off a TV tray, their body positioning may make it impossible to scoop food into their mouths. Be sure their arm position works for them. Is it easier to put their elbow on the table to maintain balance? It can act as a lever moving food from the plate to the mouth.
4. Neat and pretty. Even when using adaptive devices and feeding strategies there will be spillage. There are a variety of clothing protectors that you can use to keep their clothes clean while they practice their independence. There are adult versions that will maintain their dignity while they eat.
5. Talk them through the sequencing. Breaking down the task of feeding into smaller steps using verbal cues. Example: pick up your spoon, let’s put on some applesauce, OK good job, put some in your mouth. As things progress you can continue this process while providing more hand over hand assistance allowing them to remain involved as long as possible. Be positive and supportive as they search to keep their independence.

The Next Frontier

Technology innovators are actively searching for new solutions to help family caregivers. It makes sense that one task that they are hoping to help us with is feeding our senior loved ones.

There are robots that have been developed and are being not only tested but used with people of all types, such as children in need, people with disabilities and seniors. The robots have been programed to complete the sequencing of feeding oneself so that they can do that for a real person.

I found a study being done in Korea using assistive robots designed to improve quality of life for those needing daily care. They say that “existing robotic technologies can be utilized to take over the functions of the caregivers. Thus, assistive robots represent one of the solutions by which disabled or elderly people can receive support for performing the activities of daily life” including eating.

There are already several different robotic feeding models, including Handy1, Windsford feeder, Neater Eater, My Spoon, Meal Buddy, and the Mealtime Partner Dining System. You can read more in this article.

Who knows how this type of robot will continue to evolve to meet the needs of American family caregivers, but it is such an innovative solution we think it’s time will come.

Look for New Solutions to Your Challenge

There are also new products coming to market.

One that was designed by Sha Yao for her grandmother who had Alzheimer’s so that people with cognitive impairment could eat with more ease. Her product, called Eatwell, a special tableware for people with dementia, won first place at the 2014 Stanford Design Challenge. 

In the meantime, we can make use of the products available while we are on the lookout for new innovations in devices as well as inventions such as the robotic arms that feed.

You can also seek out the help of an occupational therapist and try some of these techniques to help your senior loved one stay independent wit eating as long as possible.