As a Service Provider, you may encounter many consumers who have specialized eating needs. When such a person comes to your home or day program or other specialized service there are probably many questions you want to ask. Here are some frequently asked questions with answers. Be sure to contact the professionals and get detailed individual answers for each consumer.

What are the signs that someone is having problems with eating, swallowing, or chewing?

The American Speech-Language -Hearing Association lists the following symptoms:

• Coughing during or right after eating or drinking. This is not normal and if recurrent should result in a thorough examination.
• Wet or gurgling sounding voice during or after eating or drinking.
• The person may need extra effort or time to chew or swallow.
• You may observe food or liquid leaking from the mouth or getting stuck in the mouth.
• Recurrent pneumonia or chest congestion after eating or drinking.
• Weight loss or dehydration from not being able to eat or drink enough.

What if the consumer does not have a special plan but those who know him tell me things like he needs a special spoon?

Take this very seriously. For a person with dysphagia (which means, "difficulty swallowing") this can be life and death. When people who have needs for specialized meal plans and they don't get them, they often aspirate, develop pneumonia and sometimes after repeated incidents, may die.

How do I get a consumer evaluated?

You must gain the support of the physician and nurse and the service coordinator. Once the physician has seen the person, then referrals may be made to the appropriate specialists. Even if an actual Mealtime Plan is not written, you should write it up so that all your staff will know how to properly assist the consumer with his meals. The key to success is for everyone to know what to do and do it consistently. Your speech therapist and occupational therapists or those who work for the Regional Center will be the best source of how to offer the meal. A dietitian or nutritionist may be able to help you with the correct texture of the food and drink and how to prepare a good diet.

I get really afraid when I see some consumers feeding themselves. Is this okay? What should I do?

You never want to interfere with a person's ability to be as independent as possible. However, safety comes first. Ask the consumer's physician and therapists if his/her eating is acceptable. Find out if the consumer has had any episodes of pneumonia in the past and how many and how long ago. Is the consumer's weight within his/her recommended weight range? Is this a health issue or is it an issue of manners and social skills? Once you get the answers to these questions, you will have an idea how to proceed. Always be cautious.

Prevention is the number 1 priority!