8 Tips for Improving Mealtimes After Your Parent's Stroke

Mealtimes can be a challenge for someone who's had a stroke -- not to mention the caregiver. These tips will help take the stress out of eating with your parent.

1. Schedule regular meals for when your parent is at his best.

Mealtimes can be hard for a stroke survivor at the best of times, but they'll be even more difficult if your parent is tired, very hungry, or uncomfortable. It's best to schedule meals at regular intervals, at the same time each day. Make sure your parent is rested and comfortable. Don't schedule meals immediately after medications that might cause nausea.

2. Get the right equipment.

A wide variety of adaptive aids are available to help you and your parent manage mealtimes:

• Easy-to-grip utensils make it easier for your parent to feed himself. (Some examples)
• Spillproof cups enable your parent to be more independent -- without the mess. (Some examples)
• Plates and bowls with suction cups stay put so your parent can focus on eating. (Some examples) Alternatively, Dycem nonskid placemats keep regular plates and bowls from slipping. (Some examples)
• If your parent has shoulder weakness, an arm support may allow him to feed himself. (Some examples)

3. Serve foods that your parent can manage.

People who've had strokes often have problems with chewing and swallowing. Throat and mouth muscles may be weakened, or there may be damage to the connection between these muscles and the brain. Talk to your parent's doctor or nutritionist about his specific needs. You can also follow these general guidelines:

• Serve soft foods cut into small pieces or chopped in a food processor. You can also add juice or broth to solid foods to make them easier to chew and swallow.
• If your parent tends to choke while drinking, adding a little powdered nonfat milk to liquids may make them easier for him to swallow.
• Avoid gooey foods like peanut butter, dry foods like crackers or popcorn, and chewy or very hard foods. Foods with tough skins may need to be peeled before serving.

4. Put the focus on eating.

It's hard enough for your parent to eat without additional distraction. To help your parent concentrate on the basic tasks required for eating, follow these simple guidelines:

• Turn off the TV and reduce background noise.
• Minimize unnecessary chatter. Don't ask a lot of questions or try to keep a conversation going. If your parent has a hard time remembering to chew or swallow, you can use simple verbal cues to remind him: "Chew that bite." "Now swallow."
• Keep place settings simple. Use solid-colored plates and bowls. If you use a placemat, choose a contrasting solid color.
• Set out only the plates, bowls, and utensils that you and your parent will need for a particular meal.
• Keep the table free of clutter.

5. Provide the right level of assistance.

Depending on the extent of your parent's disability, he may be able to feed himself or he might need your help. Let him do as much as he can on his own. If he needs help, try the following:

• Sit close to your parent's chair.
• Ask him if he's ready before you offer a bite of food.
• Use a spoon and offer food from the tip.
• Let him swallow before offering another spoonful. If necessary, remind him to swallow. You might also gently stroke his throat.
• Periodically check his mouth for food stored in his cheek.
• Wipe his mouth and offer water frequently.
• Stop when he seems tired or no longer interested in eating.

6. Know what to do in case of choking.

Because your parent may have difficulty swallowing, it's especially important for you to know what to do in a choking emergency. As a caregiver, it's a good idea for you to take a course in CPR and emergency care. To find a class near you, visit the website of the American Heart Association or the American Red Cross.

Reading a description of what to do in a choking emergency can't take the place of being properly trained, but here are some basic guidelines:

• If your parent is able to cough and speak, he probably doesn't need any emergency intervention. Encourage him to cough until his airway is clear.
• If your parent begins to turn blue or stops breathing, have someone call 911 while you start performing abdominal thrusts (formerly referred to as the Heimlich maneuver). If you're alone and haven't received emergency CPR training, call 911 yourself before trying to perform abdominal thrusts.
• To perform abdominal thrusts, lean your parent forward slightly and stand behind him. Make a fist with one hand, wrap your arms around your parent, and clasp your fist with your other hand. Place the fist between your parent's breastbone and navel with the thumb pointing inward. Quickly and forcefully thrust your clasped fist inward and upward. Keep repeating these thrusts until your parent begins breathing or loses consciousness.
• If your parent loses consciousness, transfer him onto the floor so he's lying on his back. Kneel by his side and place the heel of your hand just below the breastbone. With your other hand on top, thrust inward and upward five times. If your parent's airway clears but he's still not breathing, begin CPR.
• If your parent is obese, abdominal thrusts may not be effective. You may be able to clear his airway using chest thrusts, but these can cause rib fractures and even damage the heart muscle. It's important to be properly trained before attempting chest thrusts.

7. Schedule enough time for a leisurely meal.

Make sure your parent has enough time to eat without feeling rushed. Allow at least 45 minutes for him to eat, and then have him sit for another 45 minutes after eating so he can properly digest his meal.

8. Streamline cleanup.

Mealtime can be stressful enough without having to deal with a gigantic mess afterward. To minimize cleanup:

• Use clothing protectors. Some clothing protectors have pockets to catch spilled food. (Some examples)
• Spread newspaper or a "splat mat" underneath the table and around your parent's chair. You may be able to find a washable mat at a store that sells products for feeding babies, or you can improvise your own splat mat with a large sheet of plastic or oilcloth.
• Set out easy-to-clean placemats that can be shaken out and wiped down at the end of a meal.