On the Fourth of July 2014, a man choked to death during a hot dog eating contest. The headline seems funny at first, but the is not funny for the family and friends of the man who died. Even group home residents who do not have a history of choking could choke while eating. It is important for staff to focus on residents eating that they are present, in body and thought during meals because some residents cannot help themselves or get staff’s attention in time while choking.
CPR, a required training, can become a rusty when not used. It is important that all group home staff refresh their memory what to do when someone chokes. It is speculated that the man mentioned in the above story might have survived if the Heimlich Maneuver was used, but there is no way to know for sure.
Careful monitoring is necessary for anyone who is known to be at risk of choking.This greatly reduces the risk of injury or even death from choking. The people in the home who are not at risk may not be monitored as closely so when they choke they may not have the help they need. Ways to reduce the risk of food lodged in a resident’s throat includes the following:
- Serve food cut in manageable sizes-for residents who can be independent and cut their food, monitor the size of the pieces. Use hand over hand techniques to help assure the sizes are cut correctly. Before residents go to get their plate filled, cut food ahead of time, so there is not a battle at the table while they wait for food to be cut or risk of a resident accidentally being cut with a knife.
- Check on a resident who get up from the table while eating-some residents go to the bathroom, so they do not cough food all over. Others may isolate themselves if afraid due to the inability to breath. A group home resident in Tucson, AZ choked to death on a peanut butter and jelly sandwich when he got up from the table and went to the bathroom alone.
- Do not treat sore throats right before eating-the soothing numbing ingredients in cough medicine, lozenges, and sprays can interfere with them realizing there is food stuck in their throat.
- Follow feeding instructions-residents can be manipulating when it comes to food, so do not fall for it. If it says, no solids….it means NO solids. Staff should follow the instructions to assure that the resident’s risk of choking is reduced, and they can enjoy a meal free of choking.
- Teach residents how to eat safely-when at the dinner table do not let people talk with food in their mouths. Encourage residents to each at a slow, unrushed pace if they tend to stuff their mouths with food, and that can lead to choking.
- Serve the food at a reasonable temperature-food that is too hot or cold can be startling, and it can cause the inhalation of food and lead to choking. Help residents learn how to test food temperature before eating it.
- Change food when residents are ill-of course, mild soft foods are good for those who have a stomach ache. If someone has a cough, there is an increased risk of choking so serve softer foods and foods cut in smaller pieces. Limit milk, and any other food that can produce phlegm or mucus and cause the throat to feel like it is clogged.
- Allow adequate time for meals-residents who feel rushed may eat too fast and then their food can become lodged in their throat. When staff is in a hurry, they may not monitor the residents as closely as they should.
For high functioning residents review what to do when they feel they are choking and prepare them for what someone will do if he or she choke, this way they will not fight the person trying to help them.
Choking can be dangerous especially for a vulnerable person who is unsupervised. Always be alert while monitoring meal and snack times. Well trained and prepared support staff can make a difference in preventing choking or providing first aid in the event that it occurs and