Like butter

(I hope to high Hades that I can beat back the noise of the staff, who say my patient can't eat. We had known she was picky about her food, from before the time she had gone to the hospital. Now, she still shows little drive to eat. There are things that can be done. Sometimes everyone is a critic, but - that's why they pay you the big buckaroos.)

The patient was asleep at her table in the dining area, during the lunch hour. She was presented with a tray of pureed food, and fed bites of food and cup sips of liquid. The scoops of each item appeared to dry instantly after being served, so pats of margarine were stirred into each colored oval to add flavor, and some viscosity. The patient was instructed to take each bite and "swallow hard".

(Good gravy Gertrude - one, two and now THREE staff are stopping to watch me feed her! Well, that's good....the tsp laden with the food - mashed potato used as glue for little bits of the other, then held for the patient to see what is there - then she is asked "ready?" before each presentation: THERE YOU GO, good good - though I have to wait 1,2,3 or even 4 seconds before she closes her mouth to pull off the food, but THERE - some downward pressure on her tongue elicits that movement much more easily....)

Gradually, there is a rhythm. The patient wakes up and - especially after being given the initial bite of ice cream - opens her mouth more and more demonstrably, until she is responding to the visual cue in real time to take 90% of the bites and sips, without a verbal prompt.

(Now there's the dietician! Yes, it took some warmup to get her participation at this level, but she did it. Now, I hope the staff will see she CAN be fed....keep the viscosity at appropriate levels; assure flavor; keep the patient engaged in the process w/ coaching; move at a speed at which the patient can function; and - be positive! Find a way).

The noon meal flowed like butter, until - it was done.