Feeding and eating are essential life skills that need specialized interventions after many disease conditions

Team Udayavani, Jul 20, 2021, 10:41 AM IST

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Feeding and eating are the two basic activities of daily living that help in the acquisition of sufficient nutrition and hydration, which is essential to life. Normal humans learn feeding and eating skills on their own and become the expert with growing age. But the culture influenced the pattern of eating, food habits, etc.
In a country like India, we observed diverse types of food habits and practices across the country. These problems related to eating and feeding may include physical difficulty such as bringing food to the mouth, processing food in the mouth such as motor or sensory deficits, dysphagia, psychosocially based eating disorders such as food obsessions, maladaptive eating habits, etc.

Individuals with cognitive or physical dysfunction can decline in independence with self-feeding tasks due to their conditions. Conditions that may affect feeding independence include, but are not limited to arthritis, Parkinson’s disease, dementia, cerebral vascular accident (CVA), multiple sclerosis, upper extremity amputation, limitations of active range of motion in bilateral upper extremities, decreased fine motor control in hands, incoordination,
decreased vision, and difficultly concentrating during tasks.

According to the American occupational therapist association, Occupational therapists are long-standing expertise for managing activities of daily living problems in the feeding, eating, and swallowing performance of individuals across the life span.

Feeding, eating, and swallowing are complex activities that require practical, coordinated functions of the motor, sensory, and cognitive systems. These patterns look quite simple when we perform in daily life. It is an everyday practice we do regularly without much concern. But due to impartments due to some changes in body structure and function followed by some diseases or medical condition life of a person become, so difficulty that’s persons become partial and entirely dependent for eating, feeding, drink and increased burden on caregivers.

Problems related to feeding, eating and swallowing need expert evaluations and individualized interventions. American occupational therapy associations define feeding as “the process of setting up, arranging, and bringing food or fluid from the plate or cup to the mouth.” Sometimes it is also called self-feeding. Whereas eating defines as “the ability to keep and manipulate food or fluid in the mouth and swallow it; eating and swallowing are often used interchangeably.

The occupational therapist looks at the feeding problem from two different angles. The person entirely depends on feeding or eating activity or needs some help from the caregiver, or needs the help of some assistive and adaptive devices. They often include family members and caregivers as part of the evaluations and management process because feeding and eating occur within the social environments. If a person depends on caregivers, occupational therapy evaluates the client and suggests the best feeding and eating posture suitable to clients presents conditions.

Positioning during feeding is a top priority and should be one of the first components addressed when adult clients present with dependency on feeding. Whether seated in a wheelchair, armchair, or bed, position the adult to maximize independence and safety with feeding. Positioning for feeding is essential to prevent aspiration or choking.

Occupational therapists help select or create proper supporting devices, adaptive equipment, or environmental modifications to keep appropriate posture. They also suggest and show caregivers how to eat gradually, and feeding activities can perform in a graded manner and explain the precautionary measures during feeding and eating.

Suppose clients need help for feeding and eating activity along with the postural requirements. In that case, the occupational therapist evaluates the clients’ functional abilities and future recoveries to plan interventions for feeding and eating problems. Help also varied from client to client. A decline in one’s ability to self-feed does not need total help from a caregiver. In some cases, providing small verbal cues or slight physical assist can help increase independence. It depends on the condition’s therapies and guides caregivers to offer verbal or visual cues from time to time. The occupational therapist also recommends diet and liquid modifications consultation with the physician. The occupational therapist also creates, modify, or selects from a range of handy adaptive and assistive devices to better client feeding and eating performance.

Co-authored by Mr. Koushik Sau, Assistant Professor, Department of Occupational Therapy, MCHP, MAHE & Mrs. Lavanya Padmashali, Clinical Supervisor, Department of Occupational Therapy, MCHP, MAHE