Question about Hand Feeding

Vitruvius

I have a question about hand feeding. I thought that hand feeding would come when DW's motor control had deteriorated so that she could not manage her eating utensils. Or when she became so out of it that she was virtually catatonic.

Now however she needs to be hand fed because otherwise she will most just futz with her food. She might move it off the plate onto the table, or pour her drink over it. DW has the motor control to feed herself, she just doesn't seem to understand the process anymore. At times she will feed herself just fine, but it rarely lasts for an entire meal.

DW opens her mouth and readily accepts the food when I or an aide bring a spoon or forkful up.

So the question for those of you who's LO needs to be hand fed, is our story what prompted hand feeding for your LO?  Not that it matters that much, I'm just trying to assess DW's regression. 

Marie58

My DH is very late stage dementia. He's in MC. When he went there over 2 years ago, he was already having trouble with utensils and ate mostly finger foods, then eventually just finger foods. Then 13 months ago he had a fall. He has been bed bound and hand fed since. At first he would sometimes feed himself if you handed him something, but that didn't last very long. He doesn't even hold a cup anymore.

Belldream

The skills needed for eating have deteriorated in the last few months with my DH. Before he went into the hospital (following a fall and also having RSV), he was using utensils and feeding himself mostly fine. He has Parkinson's also and the tremor in his dominant hand sometimes presented a problem with keeping food on a fork to get it to his mouth, even with weighted utensils. I also had to cut his food into pieces for him first as he didn't have enough strength to push a knife into the food. But he was very determined to feed himself and I tried not to help unless really necessary.

Since he's been in the hospital and then rehab, he's regressed to using his fingers for any food that's served to him. The day nurse would help him eat eggs, but then let him feed himself for everything else. He would do the same for lunch. By dinner he is tired, and I am often there at that point and would feed him myself. He still has a really good appetite and no trouble swallowing so I am grateful for that, though I know that can change in a heartbeat. But it seems his use of utensils is pretty non-existent now. He does pick them up sometimes, but just half heartedly attempts to use it and then drops it somewhere. One meal, he was using his butter knife to try to eat with. Or he'll try to eat soup with a fork. So I am thinking he's lost his knowledge of what each utensil is really used for. 

This all happened in a 2 month period. It is amazing to me how so much can be lost in such a short time. One year ago, no one would look at him and think anything was off. He was doing everything for himself and my role was taking care of doctor appointments and managing the finances. Now he needs help with everything, and I am sure it is evident to anyone that he has challenges. 

ghphotog

Wow! I read these posts and it opened my eyes to how close I might be to handfeeding. I've been noticing something about how my DW has been eating lately. I normally cut up anything she couldn't cut with a fork but there has been something else and I saw it everyday for the last several weeks but but just wasn't paying attention enough when she ate to think she might be having trouble eating 

While she's eating I'm usually in the kitchen cleaning up, she comes up to me several times always with a full plate. I have to remind her that I made that food for her and to go eat. I've noticed but at the same time not noticed, that she will eat the finger foods first, bread, chips, etc then ask for more when she already has a full plate of food but it required a fork. I'll remind her that she already has a full plate and to eat that. I would hand her a fork and it never crossed my mind that she may be having trouble using it.

I will be paying more attention to that.

TGetch

We use big bowls and big spoons. My DH can't keep food on a fork any longer. And I have to hand him the spoon so that he knows it's there. My daughter found some plates with high sides that help a ton as a lot of the food was getting pushed off the plate. Also we have to turn the plate periodically as he seems to continually go to one spot. I can't leave him alone with food or beverage. We use mugs with a small opening. There have been times I've forgotten I handed him his water and it ends up on the floor. Lately I have to finish feeding him the last of his food. It's like he forgets he was eating.

Marie58

TGetch wrote:

We use big bowls and big spoons. My DH can't keep food on a fork any longer. And I have to hand him the spoon so that he knows it's there. My daughter found some plates with high sides that help a ton as a lot of the food was getting pushed off the plate. Also we have to turn the plate periodically as he seems to continually go to one spot. I can't leave him alone with food or beverage. We use mugs with a small opening. There have been times I've forgotten I handed him his water and it ends up on the floor. Lately I have to finish feeding him the last of his food. It's like he forgets he was eating.

ghphotog, I was going to reply with pretty much everything TGetch said. Another strategy I did during the spoon/adaptive plate phase was how I cut things up. DH still enjoyed all types of food. I would cut anything and everything up really small so he could spoon it up. Kitchen shears work great. Even salad became chopped salad and it worked great for a while.

ghphotog

Marie, thanks for that. I'll be looking into different bowls and plates. I'll start chopping her food up more and pay a little closer attention to this.

zauberflote

Hi Vitruvius-- MIL's appetite dropped way off towards the last few months (as I recall). She had a gentle type of dementia that was mostly overshadowed by her near-deafness and near-blindness, and was dying of COPD anyway. So it's hard to guess what caused the use of hand feeding. I think her in-home caregivers were distraught that she was that much closer to the end (several of them loved her deeply) and needed to feel they were doing something. They'd try ice cream and other soft treats, and sometimes she would accept. 

Mom, otoh, was dying of dementia. She had intermittent severe tremors, which interfered with her feeding ability. She was in MC, and could eat more easily in her room with me or a "paid friend" to pass her food, but I found that close to the end, the dining room was just too much distraction. She had no objection to me feeding her, and would say when she didn't care for any more. I am pretty sure she was seated at the big round hand-feeding table most of the time. She was not bed-bound until her last couple of days, with her final respiratory illness. She coughed so badly that we were all afraid to feed her. A short time later, she was gone. 

Beachfan

Prior to MCF placement, DH used a spork ( he had lost the ability to distinguish between spearing and scooping food).  I had to place it in his hand.  I had a flexible, clear plastic food guard that snapped onto the left side of his plate (he scooped/speared with his right hand toward the plate guard, thus keeping the food from falling off the plate).  I also put a non slip mat under his plate to keep it from moving while he maneuvered the spork.  I sat beside him and “re-arranged” the food periodically so that he could get it onto the utensil.  I usually ended the meal by feeding him the last few bites.  He was unable to manage small/side  dishes of food (ie, ice cream, cole slaw, fruit cocktail) and I would feed him these.  He could drink from a glass if I placed it in his hand, but might then place the glass precariously onto the table, often spilling.  

Several months into placement, an evening aide began feeding him his entire meal and that continues today for every meal and snack. He eats everything willingly and drinks through a straw from a glass held by an aide.  He is clearly hungry and welcomes food and drink, but I believe that he is at the point that he requires hand feeding; he lacks the perceptual and motor skills to self feed.  To expect or encourage him to self feed would only cause frustration and possibly lead to him not eating at all or to eat less than he really desires.  

Dio

So I have a slightly different question about hand feeding, please forgive the morbidity in advance.

Has anyone opted for no hand feeding? It was a question in our Advanced Health Care Directive specifically in application for dementia.

ImMaggieMae

Beachfan, thank you for bringing up the spork. I had seen pictures of those in the past but had forgotten about them. I was doing mostly hand feeding for my DH for quite a while, especially later in the day but in recent months he is insisting on eating on his own more often. He seems to prefer using a spoon for most things and often has trouble with a fork. I just ordered some sporks on Amazon. I think they may be just what he needs.

Beachfan

Maggie,

No sure which sporks you ordered. When I “shopped” I was totally confused- - so many were for camping.  They had knives attached, they extended, some looked really flimsy.  I finally bought several from Crate and Barrel.  They are sturdy and they look like high end flatware.