The new ‘Meal Observation Screen’ form has been uploaded into Resources! This form is another piece to help solve why your resident may be losing weight! Here’s an explanation why you should use it and how to use it.
When to Perform a Meal Observation Screen
This form is an important way to assess whether your resident is struggling during meals, this could be a reason as to why your resident is not eating at meals. Feeding and swallowing impairments account for up to 60% of issues residents deal with during meals.
It’s important to at least annually when assessing a resident to audit them for at least one meal, if you note any difficulties you should repeat your observation at another meal. I don’t recommend doing this in place of a Speech Language Pathologist, I recommend this as a precursor to consulting one.
An SLP is an excellent resource and most long term care homes have them available on a consult basis, meaning that they aren’t typically housed in a facility.
There are some RD’s who are now doing swallowing assessments, and I tend to advocate against this. Instead, use this Meal Observation Screen form, and if you note any impairments with a residents ability to swallow, consult an SLP immediately.
This resident could have many issues that could lead to Silent Aspiration and Pneumonia. I don’t mess around with swallowing impairments, and I don’t recommend that you do either. SLP’s have trained for an extensive amount of time in feeding and swallowing, and we are very fortunate that we have them to consult.
How to Use the Meal Observation Screen
Fill in the information at the top (demographic information), make sure to find out the accurate diet texture and fluid viscosity that the resident is on. Next sit in an area of the dining room where the resident may not notice that you are watching them. This likely will help them feel more comfortable not thinking you are watching them bite by bite.
You don’t have to sit there and stare at them like a hawk, you can be doing paperwork or reviewing things and watching them too. If you look at them every minute or two, you’ll get the gist of what is going on. Go through each question, and when you have finished, write in the comments section any other observations that you have noted.
If by the end of the observation you note that there are a couple areas of issue, discuss your findings with Nursing and Care Aides.
Nutrition Interventions After a Meal Observation Screen
Come up with nutrition interventions to address the impairments/difficulties that you noted. These could be reasons for a resident losing weight.
If a resident is constantly struggling during a meal with spilling their drinks, unable to cut their meat, unable to properly manage the cutlery, can’t see the plate well, then chances are they won’t be eating their meal.
In my experience, most residents will not seek out help, in a subtle and professional way with their permission, you can work with the staff and resident to seek out solutions that will help them with their meals.
If you want to find out how to develop a nutrition care plan for someone with swallowing difficulties, read this article!
Michelle Saari is a Registered Dietitian based in Canada. She has a Master's Degree in Human Nutritional Sciences and is a passionate advocate for spreading easy to understand, reliable, and trustworthy nutrition information. She is currently a full time online entrepreneur with two nutrition focused websites.