[Dysphagia] refusal to use hands to eat

[pressmah at sjhmc.org (pressmah@sjhmc.org)]

This sounds like a job for you and OT.  He has been fed for many years and
it takes a very long time to reverse this, if it can be done at all.  I
would suggest doing this during a therapy session, not at mealtime.  You
could work on hand over hand assist to help him understand what it is that
you want him to do.  Good luck Hilda Pressman

-----Original Message-----
From: hillivie423@adelphia.net [mailto:hillivie423@adelphia.net]
Sent: Thursday, October 13, 2005 7:51 AM
To: Dysphagia list
Subject: [Dysphagia] refusal to use hands to eat


I work with a man who has profound mental retardation.  He uses his hands to
wheel his wheelchair, holds a garden hose for about 20 seconds to water
plants (his job) but tends to hold it longer (2 minutes or more) to spray
other people, and grabs at other people to play with their arms or pull
their hair.  When he is sitting at rest, he holds his hands under the
opposite side underarm area.  He loves chocolate and sweets, but refuses to
use his hands to pick up finger foods.  He will holler, turn his head away,
and pull his hands back to refuse.  Yet, when the same food is offered to
him from the fingers of a staff member, he happily accepts it.  He also
refuses to hold a drinking cup, but enjoys chocolate milk.  Beverages must
be given after the meal is completed, by his preference.  If you give him a
drink at any time earlier in the meal, he refuses to eat any more of the
meal.  
I'd like to support this man's independence in eating but am not sure what
to do or if this is even a realistic goal.
What would be a starting point with him?
Thank you.
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