Policy: Meals will be prepared and served to residents in a manner that supports their self-feeding abilities and compensates for their losses.

Procedures:

1. General:

- Meats deboned

- No individual packets of condiments

- No small containers of butter, cream, etc.

- No straws unless specifically needed

- Napkins loose (not in plastic wrap)

- Rolls served instead of sliced bread

- Soup served in cups rather than bowls

- Foods which are same color as plate to be garnished

2. Stage Specific:

Stage 5: Decaffineated coffee unless specifically asks for regular coffee. Watch for misuse of knife and difficulty cutting.

Stage 6: When unable to use knife appropriately, provide spoon and fork only. Precut all food. Preseason food. No coffee given if will accept more nourishing liquids. Watch for misuse of fork, visual neglect of one side of tray and swallowing difficulties.

Stage 7: When unable to use fork appropriately1 provide spoon only. DIC foods not easily kept on or picked up with a spoon (e.g., rice, jello). Precut all food. Preseason food. Peel all fruit. D/C foods with outer "husks" (e.g., corn, peas).

Watch for loss of ability to use spoon (begins using fingers,) and then provide finger foods. Watch for inability to be served all of meal and/or drinks at same time.

Pureed diets: Add thickeners to mold foods or make spreads for decrusted bread. Cut bread into crouton size shapes and spread out on plate.

Onset of irreversible weight loss: Increase protein and caloric intake. May need 6 small meals a day and sweeteners added to increase sensory gratification.

Watch for swallowing difficulties and proper body positioning.

Geriatric Resources Inc.

Back to Nursing Index