Describe measures to promote a positive
atmosphere at mealtime.
Identify devices & techniques that may be used to
help the resident maintain independence.
Demonstrate how to feed a resident.
Describe and identify dysphagia and actions
Identify nurse aide actions to eliminate choking
Identify choking and demonstrate choking
PROMOTE A POSITIVE MEALTIME
Physically comfortable; position, empty
bladder, dry clothing.
Surroundings should be pleasant and comfortable.
Social aspects should be considered – converse
with resident, not co-workers!
Be positive about mealtime and the experience!
Food is in a manageable form:
cut, buttered, containers opened.
Visually impaired: Use numbers of clock to
describe location of food.
Devices: plate guard or adapted spoon.
PROPER FEEDING TECHNIQUES
Wash hands = both yours and your resident’s
Prayer, if requested
Sit facing resident
Check diet card and items on tray for match
Prevent choking: sitting, head of bed elevated
Open containers, cut, butter and/or season as preferred
Serve food in order of resident preference
Offer fluids between bites; alternate
Offer to wipe face and hands throughout meal
Spoons preferred utensil = 1/3 full
Resident should help with finger foods
Maintain flavors – don’t combine foods
Identify foods as you feed resident “Here is some mashed potatoes”
Feed hot foods cautiously
Allow adequate time to chew thoroughly
Observe, report and record food and fluid intake
Notify nurse if they refuse to eat.
DYSPHAGIA & NURSE AIDE
Difficult or painful swallowing
Risk for choking
Feed slowly, allowing time to chew and swallow.
Remind to swallow.
Offer fluids frequently.
Check for pocketed food or liquid in the cheeks.
Place food on strong side of mouth.
Support upper back, shoulders and neck with a
Observe for signs and symptoms of aspiration
when eating or drinking.
Check the resident’s mouth for pocketing after
Maintain resident in semi-fowler’s position for one
hour after eating.
NUTRITION & FLUID
NATCEP Day Twenty-Three
Discuss factors that affect nutritional status.
Identify modified diets.
Describe nurse aide responsibilities for therapeutic
Describe the dietary department’s role in providing
nutrition to the resident.
Identify the importance of hydration.
Describe methods to encourage fluid intake.
Name nurse aide responsibilities for tube-fed
Describe IV therapy and the related nurse aide’s
FACTORS THAT AFFECT THE NUTRITIONAL STATUS
OF THE ELDERLY
Tooth loss, poorly fitting dentures, and a sore
Loss of muscle control over part of the mouth and
throat as the result of a stroke.
Diminished hand and arm muscle strength or
control from paralysis or tremor.
Diminished sense of smell, taste and vision.
Decreased activity resulting in decreased
requirement for calories.
Serving foods the resident may not like.
Mood and behavior problems.
Pain and/or discomfort.
Low sodium & salt restricted: Heart or kidney
disease, fluid retention
Diabetic diet: Diabetics
Mechanical soft: Dysphagia due to
stroke, paralysis, multiple sclerosis
Pureed: Dysphagia due to
stroke, paralysis, multiple sclerosis
Nurse Aide Responsibilities
Do not interchange food from one resident’s tray to
Report resident’s request for diet substitutions to
Dietary Department Service Staff Responsibilities
Diet balanced with adequate nutrients
Food prepared and presented in way resident can
Food presented in way that is visually appealing
Infection control maintained
Tray cards provided
Identify type of diet
Identifies resident likes & dislikes
Identifies food allergies
Prevent constipation and urinary incontinence.
Dilutes wastes and flushes out urinary system.
Maintain skin turgor.
METHODS TO ENCOURAGE FLUID
Offer water each time you feed a resident
Know resident drink preferences
Some residents prefer no ice
Snacks of juice and fluids may be distributed
Offer small amounts of drinks frequently
Giving nutrients into the digestive tract through a
Person may be unable to ingest, chew or swallow
Person may be unable to pass food from the mouth
into the esophagus or into the stomach or small
Cancer or trauma to the face, mouth, head or neck
Dysphagia (difficulty swallowing)
Nose and nostril cleaned every 4 hours.
Head of bed elevated 30-45 degrees at all times.
Oral care for unconscious residents (side-lying
Care and cleaning of insertion site –wear
gloves, soap & water, rinse.
Observe for signs and symptoms of infection.
Notify nurse if taped tube is loose.
Tubes: no pulling, pinching, kinks, twisting.
Connections tight and no leaks.
Report immediately redness,
swelling, pain or tenderness.
Tubing: catching, kinking,
DO NOT TOUCH any clamps
or controls on the IV or pump.
Assist the resident with personal
care and activities with IV in