American Medical Association Family Medical Guide - American Medical Association [137]
The following tips can make it easier for the person to consume a healthful diet. Adapt them to the person’s needs:
• Slice, dice, chop, mash, or purée foods to make them easier to chew and swallow.
• Look for ways to add calories and nutrients to the diet of a person who is at risk for weight loss. For example, fortified milk shakes can be tasty and nutritious. Ask your doctor if the person you are caring for could benefit from nutritional supplements that provide added nutrients and calories.
• People with decreased appetites may consume more calories by eating five or six smaller meals throughout the day rather than three large meals.
• Ask the person what foods he or she likes or dislikes.
• Make meals look attractive.
• Eat meals together whenever possible. Mealtime rituals can be comforting and can help restore a sense of normalcy to a person’s life.
• If a stroke has paralyzed one side of a person’s body, food may tend to collect in the paralyzed cheek. If this occurs, gently knead the cheek with your finger while the person is chewing, to help move the food along.
• If the person is able to exercise, encourage and help him or her to do so. Regular exercise stimulates the appetite and helps prevent constipation. Ask the doctor which exercises are best.
Assisting With Eating
If the person cannot feed himself or herself, you must feed him or her. Cut food into small, bite-size pieces, or purée it to make it easy to chew and swallow. Before feeding the person, be sure he or she is sitting upright in a comfortable position. Tuck a napkin or hand towel under the chin to catch any spills. Taste the food to be sure it is not too hot. Because feeding someone can be a lengthy process, keep the food warm in a warming dish.
If the person cannot chew or swallow—because of oral radiation treatments, jaw injury, or stroke, for example—you may need to provide nutrition through a feeding tube or intravenously (directly into a vein). The doctor or nurse will teach you how to do this correctly and safely. Watch closely for any signs of infection: pain, redness, or swelling at the insertion site of the intravenous needle or feeding tube, or fever.
Good oral hygiene is essential for maintaining a healthy diet. Make sure that the person practices good oral hygiene (daily brushing and flossing) and that he or she sees the dentist regularly.
Special Diets
If the person needs to follow a special diet, your doctor can recommend a nurse or registered dietitian who can teach you how to prepare the food. A registered dietitian can assess the person’s dietary needs, provide guidance, and answer any questions you may have. Common special diets include low-sodium, low-protein, and liquid diets.
Low-sodium diet
You can easily reduce the amount of sodium in a person’s diet by not adding salt to food when you cook or serve it. Avoid serving foods—such as cured or tenderized meat (including ham, bacon, and cold cuts), smoked fish or meat, cheese, pickles, canned foods other than fruit, processed and prepared foods, and salted butter or margarine—that are high in sodium. Always check package labels for the sodium content of canned, prepared, and processed foods. Buy canned foods labeled “no salt added.”
If you need to further restrict the person’s salt intake, your doctor can tell you how to cut down on or eliminate foods that contain even small amounts of sodium. To add flavor to foods without adding salt, season them with spices, herbs, or lemon juice. Ask your doctor if it is all right to use a salt substitute. Most people find that after several salt-free weeks, they do not miss the salt.
Low-protein diet
To reduce the amount of protein in the person’s diet, cut down on protein-rich foods such as eggs, meat, fish, and dairy products. Because protein supplies much of the body’s energy requirements, you will need to compensate by adding