Friday, May 24, 2013

CNA Skill: Feeding A Resident

Some patients may require assistance with eating.  The amount of assistance required will vary from patient to patient, so you will need to find out what your individual patient needs.  Self-care skills such as eating are very important to patients, so you will want to allow the individual to complete as much of the task as possible.  Keep in mind that elderly or sick patients may take a long time to eat or may not have large appetites, and be sure not to rush them.  Before you begin assisting a patient, wash your hands thoroughly to prevent contaminating food.  Greet your patient, and explain that you are going to help them with their meal.  Then, follow these steps:

Ask the patient what he or she needs help to complete.  Some patients may not be able to open beverage containers or cut food into smaller pieces.  You can complete these tasks for the patient and then allow him or her to eat on their own.If the patient is visually impaired, they may only need a few verbal cues from you in order to eat their meal.If a patient is unable to feed himself or herself due to paralysis or weakness, you will need to cut each bite into small pieces and feed it to them.  Again, remember not to rush your patient, and look for signs that the patient is having difficulty with the size or texture of food.After each bite, make sure that the patient has completely chewed and swallowed the food before offering another bite.  Be sure that the temperature of food is correct, as food that is too hot may cause painful burns to the mouth.

Assisting your patient with daily tasks such as eating allows the patient to maintain a higher level of independence.  Remember that many patients will only require a small amount of assistance, and will appreciate that you provide it in a kind and courteous manner.  Your help in feeding a patient can positively impact the patient’s recovery process.

Examiners Checklist For This Skill

1) Performed beginning tasks.
2) Prepared the resident for the meal (i.e. allowed resident to use toilet
and wash hands).
3) Positioned resident in sitting position as appropriate.
4) Matched food tray/diet items with resident’s diet order.
5) Matched food tray/dietary items with appropriate resident.
6) Protected resident’s clothing, as appropriate or as resident prefers.
7) Noted temperature of food and liquids to avoid food that is too hot
or too cold.
8 ) Fed moderate-sized bites with appropriate utensil.
9) Interacted with resident as appropriate (i.e., conversation, coaxing,
cueing, being positioned at eye level with the resident).
10) Alternated liquids with solids, asking resident preference.
11) Ensured the resident has swallowed food before proceeding.
12) Cleaned resident as appropriate when completed.
13) Removed tray, cleaned area.
14) Performed completion tasks

Expert Tip By Tanya Glover, CNA

Feeding time at the nursing home can be hectic. You have to get the patients who go to the dining room to their spot. You have to pass trays to those who eat in their rooms, and you have to feed those who are unable to feed themselves. Feeding patients has always put me ill at ease. It is not that I find it unpleasant in particular; it is more about me feeling bad that this adult person needs me to feed them. I was in diapers when they were in the prime of their lives and now I am treating them like a baby! I have found that many CNA’s fell the same way and you may too-in the beginning.

If you are uncomfortable with feeding an adult, the best thing to do is to talk to them throughout the meal. Even if they never respond, or are simply unable to respond, talking can calm your nerves. For patients who are aware and just cannot feed themselves, talking puts them at ease as well. There is nothing worse seeing an aid feed a patient with a stone cold face. The patient feels as if they are just another burden and they will eat less. I have seen this with my own eyes and know it to be truth.

If you have a patient who eats very slowly, try feeding them for 10 minutes at a time and go between them and your other patients. Try to get them to eat as much as possible and take notice of their feeding chart to see if there has been a decline in their appetite.

Always remember, treat your patients how you would want to be treated, and you would not want food shoved down your throat quickly without an offer of a drink.  (Further reading: Working As A CNA: Getting Your Patients To Eat also by Tanya Glover)

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