“What Can They Eat?” Small Ideas to Consider When Serving Meals

Written by: 垣内 弘美 (Speech-Language-Hearing Therapist)

Anyone who has difficulty eating, and anyone who helps such a person eat, has surely thought at least once about “foods they can eat.” As a profession that supports eating, we speech-language-hearing therapists also think every day about what kind of meals a person can eat.

Since even professionals keep thinking about it, it is hard to say in a word what “foods they can eat” are. So in this column, I’ll share a real example as we think together about meals that are kind to people who have difficulty eating.

Imagine this for a moment

In front of you is a grandmother in her 70s. She spends her days in bed. She has never had aspiration pneumonia. She eats the same food as everyone else but can’t eat much. She often has no appetite and is getting thinner by the day.

Now, what would you do?

The meal I agonized over

With so little information, it may have been hard to answer. This is something I actually experienced when I was in my first year of junior high school, at about 12 years old.

Back then, I was desperate to get my grandmother to eat. I racked my brain over whether I could make her something before dinner, something like a snack, and with my limited knowledge of food, I thought hard and made her the following.

It was a rice ball (onigiri). So that she could get as many calories as possible in each bite, I piled rice on my palm and squeezed it with both hands as hard as I could into a triangle.

I also tried to add even a few more calories. I thought that adding dried bonito flakes (katsuobushi) would provide protein too, but gave up on the idea in case they stuck to her throat. Instead, I sprinkled on as much salt as could possibly be eaten, since salt blends well with rice. I wanted to wrap it in nori seaweed as well, but gave that up too, worried it would stick to her throat.

Finally, because I wanted her to eat it warm, I heated it in the microwave. That completed the main snack. But that wasn’t all. I didn’t forget a cup of black tea to go with it. To suit my own sweet tooth, I added three tablespoons of sugar.

I took these two items to my grandmother and quietly set them down, saying, “Eat them whenever you feel hungry.”

At dinnertime, when I went to collect the dishes, only one bite of the rice ball had been eaten, and the tea had gone down only a little.

What kind of menu would she have enjoyed?

When I remember those two items now, I regret serving something so awful. And I sometimes think about what I would consider when serving a meal if I were in the same situation today. This is just one example, but I think some points apply to other people too, so please use it as a reference for how to think about meals.

Choose foods the person “can eat”

What was overwhelmingly lacking, first of all, was the thought of choosing foods she “could eat.” The phrase “can eat” can be understood in several ways: a food you love and could eat any amount of; a food you dislike but are able to eat; and a food that your body is functionally able to eat.

In this example, no fine adjustment of food texture was needed, but given her lack of appetite, the ideal would have been to ask her what she wanted to eat and serve something from among those choices. Just as there are times when we want even our favorite foods and times when we don’t, choosing food to match the moment would probably have helped her eat more.

Think about nutritional balance

The next point is nutritional balance. Naturally, we want to avoid too much salt and sugar. They affect the taste, and in the long run they are bad for the body.

Small touches can increase appetite

There is much I regret, but some things were good.

Getting high energy from small amounts

First, I thought about a size that would be easy to eat. Squeezing the rice so hard that it lost its original texture was not a good idea, but given her poor appetite, the idea of providing high energy in a small amount was not wrong. The bonito flakes, too, could have been added if I had, for example, crumbled them finely enough not to stick to the throat. Today, side dishes and drinks that provide many calories in small amounts are sold, and pastes to eat with rice come in many flavors. Make use of whatever you can.

Serve warm food warm

I also still value serving rice warm. Serving warm food warm and cold food cold, as far as possible, helps people eat. Some foods also release more aroma when warmed. Research has found that the sense of smell declines with age, so with older people, keep this possibility in mind and find ways to help them notice the aroma.

Make it clear what the dish is

Along with smell, sight is an important element in identifying food. If the person can eat only pureed meals, show them the food before it was pureed. Or, if the person can understand words, tell them the name of the dish and its ingredients.

If a brown, mushy meal were suddenly placed in front of you, you would surely sniff it or stir it to check what was in it and decide whether it was food. And you wouldn’t feel comfortable eating it until you could guess what it was. If you were fed something without knowing what it was, you wouldn’t find it tasty. Being able to identify what a food is matters a great deal for enjoying it.

Work together, and keep talking

Those who support someone’s eating are probably experimenting with flavors and food textures to find meals the person will enjoy. But nobody has expert knowledge from the start, and nobody has unlimited time to study. Where knowledge is needed, don’t hesitate to ask professionals or others you can consult.

And at mealtimes, don’t forget to talk with the person who is eating. Simply asking, “What would you like to eat today?” or “Would you like tea or juice?” helps them get mentally ready for the meal. And when someone tells me, “I don’t want to eat,” I don’t push them; I respect their wishes.

The person who is eating knows best what tastes good to them at any given moment. I hope those who support eating will adjust the appearance, flavor, temperature and form of food, and keep talking with the person as they create delicious meals together.

---

About the author: 垣内 弘美 (Speech-Language-Hearing Therapist)

This article is a contribution from a medical or care professional, re-edited by our editorial team. It provides general information as of the time of writing, and symptoms and circumstances differ from person to person. For specific decisions, please consult your doctor, dentist, pharmacist or another professional.

This is an English translation of a column originally published in Japanese by Next Co., Ltd.

About Next Co., Ltd. We are a Tokyo-based company working in Japan’s senior care and end-of-life planning field. Alongside these expert columns, we publish professional training textbooks and support businesses entering Japan’s eldercare market. More expert columns | Our English textbook | Contact us