Clinical Mealtime Observations
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The relevant areas to address are taken from Groher and Crary (2010). Explanations have been kept brief as these are discussed in the intervention section.

Posture: the safest position for eating is an upright position, which can be difficult if the individual does not get up for all meals. The SLT needs to assess whether they are positioned safely whether in bed or a chair. Individuals with moderate to late stage dementia may require assistance with positioning.
Self feeding skills: assistance may be required for feeding as individuals with moderate to late stage dementia may not have the ability to feed themselves. SLT will observe whether the mouthfuls they are given are an appropriate amount and whether they are reminded to swallow frequently.

Self-feeding difficulty can be attributed to a number of factors according to Groher and Crary (2010 p.81). These include:
•Cognitive impairment
•Motor deficits (weakness or apraxia)
•Loss of appetite and food avoidance.
•Visual deficits may also contribute to their self feeding skills.

The SLT needs to ensure that previously instituted dysphagia guidelines are being followed by nurses and nurse aides.

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