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Going to Bed
Food and Drink – Getting to know you
Food & Drink, getting to know you
justin
2022-11-10T17:38:14+00:00
Food & Drink
Geting to know you
How often do you see them?
*
Daily
Weekly
Monthly
Do they live with you?
*
Yes
No
Can you provide a description of the mealtime routine through the day?
*
Yes
No
1. Have there been any significant change in their appetite or eating or drinking?
Yes
No
1.1 In the last few days?
Yes
No
If yes, what changes have you observed? Does their eating vary day-to-day or within a day or over a meal?
2. Can you provide as much information as possible on their usual food or drink intake. Do they eat/drink at breakfast?
Yes
No
At breakfast: Food and drink they like or dislike? How much? When?
3. Do they eat or drink mid-morning?
Yes
No
Mid-morning: What food and drink they like or dislike? How much? When?
4. Do they eat of drink at lunchtime?
Yes
No
At lunch: What food and drink do they like or dislike? How much? When?
5. Do they eat or drink mid-afternoon?
Yes
No
Mid-afternoon: What food and drink do they like or dislike? How much? When?
6. Do they eat or drink at tea time?
Yes
No
Tea time: What food and drink do they like or dislike? How much? When?
7. Do they eat or drink at suppertime?
Yes
No
Suppertime: What food or drink do they like or dislike? How much? When?
8. Any other information you would like to give? E.g. weight loss/increase. Do they were dentures? Do they have problems with swallowing? Are there any special dietary needs, e.g. modified or soft diet, thickened fluids, allergies, etc?
How does the person usually eat and drink at home?
Do they sit at the table?
*
Yes
No
What do they prefer?
Needs prompting to sit/remain at the table?
*
Yes
No
Do they prefer to eat at a table with others?
*
Yes
No
Other comments:
Needs assistance or prompting?
*
Yes
No
Prompting verbally?
*
Yes
No
Needs prompting to chew?
*
Yes
No
How?
Needs prompting to swallow?
*
Yes
No
How?
Can they locate crockery/cutlery on the table?
*
Yes
No
Needs assistance to locate cutlery or plate?
*
Yes
No
How?
Are they distracted by other items on the table?
*
Yes
No
Do they need assistance to be fed?
*
Yes
No
Is this for all Food or for Drinks?
Packaging around food and drink
Are they able to attempt to open things?
*
Yes
No / Unable
Other comments about opening things:
Needs aids or adaptations?
Needs special cup/straw/thickened fluids to drink?
*
Yes
No
Describe the aids used:
Recognises cutlery?
Yes
No
Able to use cutlery with their hands?
*
Yes
No
Special cutlery required:
*
Yes
No
Describe cutlery used:
Are they better with finger foods?
*
Yes
No
What do you use at home, give examples:
Submit
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