Mealtimes can be a challenge for someone who's had a stroke -- not to mention the caregiver. These tips will help take the stress out of eating.
1. Schedule regular meals for when the stroke survivor is at his best--and allow enough time.
Mealtimes can be hard for a stroke survivor at the best of times, but they'll be even more difficult if he's tired, very hungry, or uncomfortable. It's best to schedule meals at regular intervals, at the same time each day. Make sure the person in your care is rested and comfortable. Don't schedule meals immediately after medications that might cause nausea.
Also, make sure he has enough time to eat without feeling rushed. Allow at least 45 minutes for him to eat, and then have him sit for another 45 minutes after eating so he can properly digest his meal.
2. Get the right equipment.
A wide variety of adaptive aids are available to help you and a stroke survivor manage mealtimes:
- Easy-to-grip utensils make it easier for him to feed himself. ( Some examples )
- Spillproof cups enable him to be more independent -- without the mess. ( Some examples )
- Plates and bowls with suction cups stay put, making it easier to focus on eating. ( Some examples ) Alternatively, Dycem nonskid placemats keep regular plates and bowls from slipping. ( Some examples )
- If the person in your care has shoul der weakness, an arm support may allow him to feed himself. ( Some examples )
3. Serve foods that a stroke survivor can manage.
People who've had strokes often have problems with chewing and swallowing. Throat and mouth muscles may be weakened, or there may be damage to the connection between these muscles and the brain. Talk to the doctor or nutritionist about his specific needs. You can also follow these general guidelines:
- Serve soft foods cut into small pieces or chopped in a food processor. You can also add juice or broth to solid foods to make them easier to chew and swallow.
- If the person you're caring for tends to choke while drinking, adding a little powdered nonfat milk to liquids may make them easier for him to swallow.
- Avoid gooey foods like peanut butter, dry foods like crackers or popcorn, and chewy or very hard foods. Foods with tough skins may need to be peeled before serving.
4. Put the focus on eating.
It's hard enough for a stroke survivor to eat without additional dist raction. To help him concentrate on the basic tasks required for eating, follow these simple guidelines:
- Turn off the TV and reduce background noise.
- Minimize unnecessary chatter. Don't ask a lot of questions or try to keep a conversation going. If he has a hard time remembering to chew or swallow, you can use simple verbal cues to remind him: "Chew that bite." "Now swallow."
- Keep place settings simple. Use solid-colored plates and bowls. If you use a placemat, choose a contrasting solid color.
- Set out only the plates, bowls, and utensils that you'll need for a particular meal.
- Keep the table free of clutter.
5. Provide the right level of assistance.
Depending on the extent of the dis ability you're dealing with, the stroke survivor in your care may be able to feed himself or he might need your help. Let him do as much as he can on his own. If he needs help, try the following:
- Sit close to his chair.
- Ask him if he's ready before you offer a bite of food.
- Use a spoon and offer food from the tip.
- Let him swallow before offering another spoonful. If necessary, remind him to swallow. You might also gently stroke his throat.
- Periodically check his mouth for food stored in his cheek.
- Wipe his mouth and offer water frequently.
- Stop when he seems tired or no longer interested in eating.
6. Know what to do in case of choking.
Because many stroke survivors have difficulty swallowing, it's especially important for you to know what to do in a choking emergency. As a caregiver, it's a good idea for you to take a course in CPR and emergency care. To find a class near you, visit the website of the American Heart Association or the American Red Cross .
Reading a description of what to do in a choking emergency can't take the place of being properly trained, but here are some basic guidelines:
- If he's able to cough and speak, he probably doesn't need any emergency intervention. Encourage him to cough until his airway is clear.
- If he begins to turn blue or stops breathing, have someone call 911 while you start performing abdominal thrusts (formerly referred to as the Heimlich maneuver). If you're alone and haven't received emergency CPR training, call 911 yourself before trying to perform abdominal thrusts.
- To perform abdominal thrusts, lean the person forward slightly and stand behind him. Make a fist with one hand, wrap your arms around him, and clasp your fist with yo ur other hand. Place the fist between his breastbone and navel with the thumb pointing inward. Quickly and forcefully thrust your clasped fist inward and upward. Keep repeating these thrusts until he begins breathing or loses consciousness.
- If he loses consciousness, transfer him onto the floor so he's lying on his back. Kneel by his side and place the heel of your hand just below the breastbone. With your other hand on top, thrust inward and upward five times. If his airway clears but he's still not breathing, begin CPR.
- If he's obese, abdominal thrusts may not be effective. You may be able to clear his airway using chest thrusts, but these can cause rib fractures and even damage the heart muscle. It's important to be properly trained before attempting chest thrusts.
7. Streamline cleanup.
Mealtime can be stressful enough without having to deal with a gigantic mess afterward. To minimize cleanup:
- Use clothing protectors. Some clothing protectors have pockets to catch spilled food. ( Some examples )
- Spread newspaper or a "splat mat" underneath the table and around his chair. You may be able to find a washable mat at a store that sells products for feeding babies, or you can improvise your own splat mat with a large sheet of plastic or oilcloth.
- Set out easy-to-clean placemats that can be shaken out and wiped down at the end of a meal.