Eating/Drinking Helpful Hints Jean E. Miller
Some things we used and/or read about

Eating/Drinking Helpful Hints

At some point, a person with Huntington's Disease may have difficulty
eating and drinking. Some of this difficulty is related to the weakness
of the swallowing muscles. Other difficulties are a result of weakening
hand, arm and shoulder muscles.

With chewing and swallowing weakness pHD's must make changes in
their dietary consistency meaning they have to eat softer foods and
avoid thin liquids.

This deals with adaptive equipment that will help pHD's who are still
able to eat and drink on their own.

EATING UTENSILS

Finger and hand atrophy or weakness may make it difficult to hold a
conventional knife, fork or spoon. Utensils with built-up handles are
much easier to use. A sample can be seen at

http://store.yahoo.com/healthline/surgriplarha.html

However these can also be bought in most retail stores for people
with arthritis.

Another idea is to use the foam rubber larger curlers (removing the
plastic curler) and place those over the utensil. This makes them
easier to grip, is soft on the hand and they can be washed or thrown
away. We used pink, or course, for Kelly!

For someone who has a tendency to bite too hard on their utensils,
there are some with rubber coatings that can be used. To see a sample
go to http://www.wisdomking.com/product16120c250.html

Some brands of bicycle handlebar grips fit ordinary household cutlery,
the "fatter grip' can lessen choreic movements.

PLATES

Use plastic plates that will not break when you drop them!  Special
plates with raised edges make it easier to eat. You can push the
food against the edge to make it easier to get it on your fork.

Make sure any plates that you buy are microwave safe. Speaking of
mircowaving a tip I use is to wet a paper towel, squeeze dry, and
use to cover food to keep from splattering and keep moisture in!

There is a handy little device that clips onto plates to keep food from
being pushed off. A sample can be seen at

http://www.wisdomking.com/product16110c250.html

Or they make plates with suction cups on the bottom. To see a
sample go to

http://www.wisdomking.com/product15794c246.html

Also, the microwave type plates with dividers help keep foods from
getting mixed up on them.

CUPS

Cups or mugs with handles are easier for pHD's to grab. Plastic cups
are the best. The plastic travel mugs with lids work great.

So do the sports jugs. If you happen to tip over or drop one of these
mugs, you end up spilling a lot less liquid. There are several special
cups for Dysphagia.

One is "Limited Flow"
http://reliantmedicalproducts.com

You can also find sports drinking cup holders that can be placed around
the neck where the cup sits on the chest and the straw is accessible
by just bending the head down. Kelly used one of these when her
hands were too shaky to hold a cup.

The sports drink containers Kelly used were shaped like an hour-glass
making it easier for her to grasp.Go here to see a picture of the shape

http://www.imagestation.com/picture/pb0fc82a90612520eacd8b03aecc8ac9d/feb0e3bc.jpg.orig.jpg

Straws

Straws are essential for pHD's. Straws are also helpful to drink with your
chin tucked down, which helps prevent aspiration and choking.

There are some straws with clear plastic tubing with a wider diameter
opening which requires less effort to drink more which are used by a
hospital x-ray department for patients who had to swallow barium prior
to x-ray.

Check with your local radiologist or hospital to see if you can obtain some
of these straws or if they will order some for you. Most hospital social
services or patient administrators will assist you in ordering special products
to help with meals and baths, often ordering them for you if your doctor
approves and your insurance covers them.   If insurance doesn't cover
them, typically they'll order and you pay them when the product is received.

Molds (Pureed foods)

One common dislike of pureed food is that most of it looks like a big blob
of gunk on the plate!

Just because a meal has to be pureed is no reason not to make it appear
appetizing!! One thing I did was to prepare the food normally, then show
Kelly what it was before pureeing it. That way she got a visual picture of
what she was going to eat.

You can also use molds for pureed foods to make them appear more appetizing.
 
For some idea visit

http://www.atlantic-pub.com/garnishing_three.htm

Trays

Sometimes it is easier for a pHD to eat sitting on a couch or recliner.  A
bed-type tray with edges large enough to fit over a pHD's lap can be used.
Lining the tray top with a rubber mat or non-slide material will help keep
plates from sliding.

Chorea

A velcro weights can be secured to the wrist, helping to steady the hand
used for eating. These can be found at most sports stores or if you get
the primary care physician to write a prescription for them, the cost is
covered by insurance. Samples of these can be seen at

http://store.yahoo.com/healthline/wrisandanwei.html

The ankles ones come in handy for people whose legs have chorea and
who have a difficult time keeping them still, especially at meal time.

Clothing Protection

With unsteady hands accidents with foods are a natural. Protective coverings
help preserve clothing and with clean ups.

Normal bibs can be used but are sometimes an embarassment for an adult.
Attractive aprons can be bought, or even made. I stocked up on plain ones
from arts and craft places like Michael's that could be left plain or decortated.
Plus they have some really cute/cleaver ones in the BBQ departments
especially for men.

Support

Bolster pillows to help person upright during meals can be placed on both or
one side of the body if the person has a tendency to lean.

Those rolls of rubber you can put to line your cabinets also help by cutting
pieces to place under buttocks or back to help keep the person from sliding
during meals.

Or cutting the egg-crate foam rubber you can buy in bath/bedrooms sections
of Walmart, etc. can be cut to fit to help from sliding.

Rubber mats under dish, drink, etc. helps keep them for sliding. I bought the
rubber sheets you can cut to any size at Walmart.


Some Product Catalogs: (do a search for Aids In Daily Living)

Aids in Daily Living
http://www.wisdomking.com/page1.html

CurveWare
http://www.curvware.com/

Dr. Leonard's Home Health Catalog
http://www.drleonards.com/Contact.cfm

MaxiAids
http://www.maxiaids.com/

MOMS
http://www2.momsup.com/moms/


Thickners

Diamond Crystal pre packaged shakes, bev., thickners
http://www.diamondcrystal.com/

Hornel Foods
http://www.hormelhealthlabs.com/history.htm 

Precision Foods-Thick It
http://www.bonmelange.com/consumer/thick.asp

FOOD CONSISTENCY Jean E. Miller
Description of 4 types of consistency for various stages of eating.

Overview

By modifying the consistency and texture of foods and fluids, the risks
of aspiration are decreased. Diets have been devised that will help
maximize your intake of nutrients, calories and protein while conforming
to your limitations in swallowing certain food textures and consistencies.

These diets can be divided into four stages. The diets progress from
regular foods to pudding consistency. Frequent small meals (chosen
from the appropriate stage) are preferable to three large meals.

When changes in consistency of foods become necessary, it is useful
to think in terms of familiar foods. Four diets for patients with swallowing
problems can be:

Steak Consistency Diet - regular food

This diet consists of regular foods and liquids without restrictions and is
recommended only for persons with normal chewing and swallowing function.
No modification in texture or consistency is made.

Pot Roast Consistency Diet - soft food

This diet consists of foods that are easy to chew and that can be held
together in the mouth. It requires active chewing of soft cooked meats
and vegetables. Foods that provide needed fiber should be allowed
whenever possible.

Care should be taken to eliminate foods which contain particles (i.e.,skins,
seeds, raisins, nuts) or foods that can easily break apart in the mouth
(i.e., dry cottage cheese, dry scrambled eggs, dry cereals). 'Crumbly' foods
should be eliminated (i.e., crackers, corn bread, cookies, dry cakes) to
minimize swallowing difficulty.

It is suggested that you eat three balanced meals. Snacks can be added
as needed to maintain adequate weight

Meat Loaf Consistency Diet - soft, chopped food

This diet consists of soft textured foods that are easy to chew and swallow.
All meats are finely chopped or ground with added gravies and all vegetables
are chopped. Foods should be easily held together in the mouth and require
less chewing. Foods that provide needed fiber should be allowed whenever
possible.

Foods containing particles (i.e., skins, seeds, raisins, nuts) or foods that
can easily break apart in the mouth (i.e., dry cottage cheese, dry
scrambled eggs, dry cereals) are eliminated.

All liquids including soups should be thickened using agents such as dried
skim milk powder, cornstarch, pudding and pie filling mix, strained fruit, flour,
or commercial thickeners such as Thick 'N Easy or Thick-It. All "crumbly"
foods are omitted (i.e., crackers, corn breads, cookies, dry cakes) to
minimize swallowing difficulty.

Pudding Consistency Diet - soft, pureed food

This diet consists of foods that require minimal chewing, and foods that are
easily swallowed.

Foods may be blended with gravies and sauces to increase calories and to
make the food easier to form into a bolus in the mouth. You may use a
blender to blend foods or you may wish to purchase strained or pureed foods.
Foods that provide needed fiber should be allowed whenever possible.

All foods containing particles (i.e., skins, seeds, raisins, nuts) or foods that
can easily break apart in the mouth (i.e., dry cottage cheese, dry scrambled
eggs, dry cereal) are eliminated.

All liquids including soups are thickened and all "crumbly" foods are omitted
(i.e., crackers, corn bread, cookies, cake, etc.) to minimize swallowing difficulty.

Suggestion

Reference:
http://www.bcm.tmc.edu/neurol/struct/als/als6s.html