Nutrition, Hydration, and Feeding
Mealtime
Check the diet card against the tray and confirm the resident's identity. Verify the diet, the liquid consistency, and any allergies. Position the resident upright, at least 90 degrees, before feeding, and keep them upright for about 30 minutes afterward. Sit at eye level, offer small bites, alternate with fluids, and allow time to chew and swallow. If there is one-sided weakness, place food on the unaffected side of the mouth. Keep the head slightly forward or chin tucked. Record the percentage of food eaten.
Aspiration and hydration
Signs of dysphagia include coughing or choking during meals, a wet or gurgling voice, pocketing food, drooling, and a feeling that food is stuck. Stop feeding and report. Encourage fluids; signs of dehydration include dark urine, dry mouth, poor skin turgor, and new confusion. Follow fluid restrictions exactly and report weight loss.
Traps
Feeding a resident who is lying down or drowsy. Rushing, or putting in food while the resident is still chewing. Letting a resident on thickened liquids drink thin liquids. Forgetting to check that dentures are in and glasses are on. Guessing intake instead of estimating in quarters or measuring in milliliters.
Rule of thumb
A wet cough or a gurgly voice during a meal means stop feeding, sit the resident upright, and get the nurse.