Study carefully and choose food carefully

In our daily work, we often hear patients and their families say: "Our patients eat very well in the treatment room, but they choke when they return to the ward or go home, and food easily flows out of their mouths. Doctor, what's going on?" With these questions, today I will share with you some knowledge about how to eat after swallowing disorders, mainly from the choice of food, the choice of tableware, and the management of some postures during feeding, to escort your "eating".

01 Food selection Generally, choose food that is easy to swallow: soft, uniform in density and shape; with appropriate viscosity and not easy to loosen; easy to chew, not easy to deform when passing through the pharynx and esophagus; not easy to stay on the mucosa, etc. It is best not to choose food that is crispy, needs to be chewed, liquid, with bones, or mixed texture.

02Choice of tableware

According to the swallowing function, try to choose a spoon with a small, shallow surface and a long handle to facilitate feeding.

Patients with weak grip ability can choose cutlery with thick handles to facilitate a secure grip.

03Body position management during feeding

(1) Patients who can sit up should try to eat while sitting. Sitting on a chair with a backrest, facing a dining table of appropriate height, with the upper body leaning forward and both feet completely on the ground is the most ideal posture for eating. It can maintain a stable posture and will not cause the risk of aspiration. In addition, patients who have difficulty controlling left and right balance due to hemiplegia can choose a chair with armrests. Hanging the feet from the bed to maintain a sitting position is also an acceptable posture. A table of appropriate height should be prepared next to the bed (at the same level as the navel when sitting). In addition, in order to stabilize the body, the heels must be completely on the ground. Adjust the height of the bed so that the heels are not suspended in the air.

(2) Patients who cannot sit up should generally be placed in a semi-recumbent position of at least 30°, with the head slightly bent forward and swallowing on the healthy side. Eating in a supine position is contraindicated.

(3) Maintain a safe environment while eating, avoid distracting the patient, and avoid talking to the patient while eating.

(4) Maintaining posture after meals: The patient should not lie down immediately after eating. Allow the patient to rest in a comfortable sitting or semi-sitting position for 30 minutes.

(5) The mouth needs to be cleaned after meals to reduce the risk of pneumonia caused by aspiration of food and saliva. Patients with better swallowing and cognition can clean their mouth by gargling, brushing their teeth or cleaning their dentures; patients with more sputum can use a suction toothbrush for cleaning.