The Safety Net

Spotting and Intervening With Unsafe Mealtime Practices


As a staff member at a Regional Center, you may be in a position to spot unsafe mealtime situations. You should be prepared to identify when a situation is not as it should be and suggest immediate corrections or assist in getting a trained person to assess the situation. Staff working with those at risk for mealtime problems will need extra training and extra support to understand the reasons why mealtime plans must be followed to the letter.

Dysphagia is a term that means "difficulty swallowing". This is a condition that affects many of the consumers with whom you come in contact. It occurs when there is a problem with any part of the swallowing process. It may occur as the result of cerebral palsy, brain injury, medication side effect or any of a long list of other conditions. How can you tell if a consumer is at risk while eating? If you see or hear any of the following, it is a warning sign:

  • Coughing during or right after eating or drinking. This is not normal and if recurrent should result in a thorough examination.
  • Wet or gurgly 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.

If any of these conditions exist, there are steps to be followed;

  1. Be sure the individual has a complete medical evaluation with referrals to specialists for further testing until it can be determined whether or not there are risks when the consumer eats.
  2. If further referrals are needed, help to get them as quickly as possible.
  3. Be a part of the team that develop one or more mealtime plans.
  4. Take any training offered by the Regional Center or other qualified provider so that you become better able to support consumers who may need special meal time plans.
  5. Ask questions to understand the problem and the recommended treatment.
  6. Assist caregivers to obtain the necessary adaptive mealtime equipment and positioning equipment. Know your sources.
  7. Get involved! If you see anyone having difficulty eating, don't accept the old answer, "Oh, that's just how she is". This is not normal and can become life threatening. On the plus side, intervention can greatly improve the quality of a person's life.

Now, that's worth it!


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