Wednesday, March 4, 2015

Change a Spoon and Change Your Life

Why is it that people who need it least are the most likely to get it?

Have you ever asked yourself this question?

As a speech therapist, I do it every time I walk into a dining room and find a person with a modified diet eating with a tablespoon. Where is the logic behind this? Why should we give a person with feeding or swallowing problem the biggest spoon in the kitchen? It only complicates an already challenging situation. On the bright side, I suppose, it does provides an opportunity for professional intervention.

Often, unable to find a more suitable utensil, it is customary to attempt to modify a big bite behavior with verbal cues and prompts. These are just a few of my favorite "friendly reminders:"

Level one- general introduction
Be sure to take small bites.
Your spoon should be no more than half way full.

Level two- educational suggestions and rationale
You will be safer and have less trouble if you take smaller bites.
It's easier to chew if there is less food in your mouth.
Try to have less food on your spoon with the next bite.
Take some of that food off the fork before you take that bite.

Level three- last resort
Wow, that's a really big bite!
That's way too much food to put in your mouth at once!
I'm not sure you will be able to open your mouth wide enough to put all of that food in there.
Are you trying to set a new world record?

Before you resort to stage three remarks, I recommend you begin the hunt for a replacement utensil. That's exactly what I did today.

Upon arrival, the patient was using this built up spoon. It had been provided by a good hearted Occupational Therapist somewhere along the way. I'm sure it was very useful and appropriate at one point. These days, however, the patient was using it to take heaping spoonfuls of catfish and asparagus. His mouth was so full of food, that it was spilling out as he chewed. It was no wonder that there were reports of coughing and choking during meals!

I asked the family to try using a long handled teaspoon. It has a smaller, more shallow bowl and holds less food.   They reported back that, without the rubber gripper, the spoon would "clang" against the plate. The patient was annoyed by the clanging and had trouble manipulating the longer handle.

Well, come to find out, the grip was removable- yay!

I gave the caregiver permission to lose this weird but enormous spoon...forever. She agreed!

Hmmm. Now we have a huge gripper. What can we fill it with? I know, a long handled tea spoon!

To fill the void, I wrapped the base of the spoon with a piece of paper towel...

inserted the teaspoon...


Wow, what a difference!

So, the next time you find yourself tempted to let a level three comment slip out during a dysphagia therapy session, consider your options for utensil modification and remember my blog: Change a Spoon and Change Your Life!

Who do you know that needs a new spoon?

Life does not get better by chance, it gets better by change.
Jim Rohn