Practical advice for people who have difficulty in eating

Before the meal, the patient does not open his or her mouth : consult the doctor or a speech therapist ; stand in front of the patient and touch their lips gently with the spoon.
The patient refuses all food and becomes agitated : try again a little later and keep calm !
He/she stares at the food and doesn’t eat : speak encouragingly, try to help them
The patient does not seem to see the food or what is on the table : check sight with an opthalmologist.
He/she has aphtae or the mouth is dry : use a mouth wash (dentist), give plenty of fluids, icecream lollies, fruit lollies. Dip fingers of bread or rusks in fluids, serve food with sauce, or well-seasoned raw vegetables but without too much vinegar or lemon juice. Rinse the mouth often, give pastilles to suck.
The patient has forgotten he/she has already eaten : offer some grapes, a rusk, a piece of apple, a cube of cheese, etc.
In case of weight loss :

Call your General Physician
During the meal
The patient mixes everything up : give him/her each dish in turn.
The essential thing is that the meal should be eaten, it does not matter if the various foods are mixed up.
The patient eats too quickly : serve small portions, encourage him/her to slow down (verbally or by signs)
He/she does not hold the cutlery properly : special cutlery can be found in certain outlets, or see an occupational therapist.
He/she eats very slowly : heat the plate
He/she does not chew properly : check teeth and gums (dentist), prepare "mushier" food, encourage him/her to chew (verbally or by massaging the cheeks).
He/she complains the food tastes strange : check teeth and gums, marinate the meat, chicken, or fish in orange or lemon juice ; give plenty of fluids or pastilles to suck. Serve food when it has cooled or at room temperature. Make use of herbs, spices, lemon juice, mint. Check the list of medications with the doctor
The patient turns the food around in the mouth but does not swallow it : change the consistency of the food, massage the cheeks lightly, encourage him/her verbally to swallow.
The patient will not eat meat : replace it with other high-protein foods : milk desserts, baked custard, yoghurt, soufflés, boiled eggs, etc.
The patient cannot swallow : consult the doctor, a speech therapist.

Difficulty in swallowing

The patient cannot swallow : consult the doctor, an ENT specialist, a speech therapist. The food "goes down the wrong way" : gelatine, cornflour or thickening powders (from chemists) make liquids thicker and creamier ; puréed fruit can replace fruit juice and yoghurt can replace milk. Cold liquids can be thickened with biscuit, icecream or sorbet.
Other problems :
The person feels sick or vomits : give smaller, more frequent meals, ask him/her to chew slowly and longer, sip cool drinks between meals, rest after meals with the head raised, avoid too spicy, fried, fatty or strong-smelling foods ; serve food cold or at room temperature.
The person is constipated ; give plenty of fluids and high-fibre food. Physical exercise should be regular. The person has diarrhea : serve small meals (several during the day), give plenty of fluids (vegetable consommé or stewed fruit), avoid fatty and high-fibre foods.

How to make meals more nourishing

Various ingredients can be added to make meals more nourishing : eggs, ham, powdered milk, unsweetened condensed milk, baby food, grated gruyère, minced beef, sausage meat, fish, mussels, powdered protein (from chemists).
Some savoury foods which are easy to eat and easily enriched : soufflés, croquettes, rolls, baked custard, mousses (fish, meat or vegetable), white sauces (fortified milk, egg or cheese), baked gratins (fortified milk, egg or cheese), soups (added egg, ham, fresh cream or gruyère), purées enriched with fortified milk or gruyère, piperade (eggs with peppers and tomatoes), omelettes (potatoes, onions, cheese or herbs), stuffed vegetables, ravioli, lasagne, gnocchis, chicken liver meatloaf, meat croquettes, purée de courgettes, fish quenelles, quiches.
Some sweet foods which are easy to eat and easily enriched :
confectioner’s custard, baked custard, creamed rice and semolina, puddings, icecream, eggnog, bread-and-butter pudding, enriched chestnut purée + petit suisse, milkshakes.
Commercial foods with added protein (from chemists), nutritional mixtures, custards, soups, blended foods, energy bars, fruit juices with added nutrients, homogenized baby foods (meat, vegetables), powdered protein, breakfast energy foods in powder form.
Fruit juice, milkshakes or milk can usefully replace water and provide energy, vitamins, protein etc. Supermarkets now stock with the fresh dairy products a new product which is a mixture of milk and fruit juice (serve cool).

What makes a balanced diet ?

Dairy products at every meal
Meat, fish or eggs at least once a day
Raw vegetables or fruit at every meal
Cooked vegetables once a day
Potatoes, pasta or rice once a day
Bread with every meal and water always available
Food which can be eaten with the fingers :
Mixed sandwiches with a choice of lettuce, tomatoes, mushrooms, savoury olive and caper paste, chicken, cheese, sliced radishes, fresh goat cheese, potted salmon or tuna, omelette, hard-boiled egg, etc.
Sausage, cold chicken, vegetable tarts, surimi
Sticks of raw vegetables, cheese, meat or fish croquettes, gnocchis, cold chicken, sausage, quiche lorraine, pizza
Icecream, sweet pancakes, biscuits, fruit tarts, desserts.

How to measure weight

Weigh the person regularly (every month)
always on the same scales
wearing the same clothes
at the same time of day

Keeping up regular exercise

Walk for 30 min before the two main meals
or for 30 or 45 min every day before the evening meal
or for 45 min three times a week