Observations of assisted feeding among people with language impairment

This study examines the phenomenon of assisted feeding among people with language impairment.

Patients' experience of assisted feeding is influenced by the caregivers' availability and their other responsibilities. Also, caregivers and patients may have different values with respect to assisted feeding.

Instances of assisted feeding (n=42) were observed among people with language impairment admitted to a neurological ward. Field notes were taken simultaneously and in some cases a few simple questions were posed to the caregivers or the patients. All notes and answers were analysed using the phenomenological guidelines of Dahlberg and colleagues (2008, Studentlitteratur AB, Stockholm).

The essence of assisted feeding among people living with language impairment was identified to be a transaction characterised by efficiency. The constituents of the essence were in the shadow of institutional structures, accidental relationships with potential humiliation, meal-related conventions versus respect for the individual's wishes, sense of joy threatened by goal-related determination' time being significant for the course of the meal.

This study shows that assisted feeding is not important enough to postpone other activities in a neurological ward. Although assisted feeding is an opportunity to enjoy mutual contact and exchange information between the patient and the caregiver, it is a situation where the nutritional aspect of the meal tends to take precedence. We recommend that the focus of recent years on the patients' nutritional status is now supplemented by improvement in the relational and affective aspects of meals, especially for people who require assistance to eat.

The findings indicate that the institutional conditions for meals need to be reconsidered. For instance caregivers could be exempted from other responsibilities during mealtimes. More flexible time-limits for meals depending on the number of patients with extensive assistance needs is another possibility.