How do occupational therapists help with eating after a spinal cord injury?

When someone has difficulty eating after a spinal cord injury, we really break down the tasks and look at each component of eating, and what equipment they need to support that. So it starts with being able to get the food off the plate. We’re looking at do they need something to help them hold the utensil? Do they need a utensil that’s easier to hold? Do they need something or somebody to support their arm while they’re scooping that food off of their plate? From there, once they have it in their hands, can they bring the food up to their mouth without spilling, dropping it all over themselves? Then we’re also looking at can they manage a beverage? Can they get the cup up to their mouth? Do they need a longer straw so the cup just stays on the table, on their chair and they move their head to get to it? We’re looking at the set-up of the table. Do they need somebody to cut their food up? Do they need a specialized knife? Does their plate need to be an adaptive plate that has a higher side so they can push the food into it to get it onto the fork or spoon. People always tell me, “I had no idea there was so much that goes into eating!” And before a spinal cord injury, it’s something we do without thinking. And afterwards as occupational therapist, we have to break down that task, look at the different steps and then take a look at what equipment could benefit the patient to do that.

If someone has a difficult time holding a fork for example, we use a lot of everyday common things like maybe some foam or something to place around the handle of the fork to make it wider so the person can hold it. We might not even need an extra material like that, we might just be able to teach the person how to weave the fork in between their fingers and be able to use a standard utensil, especially if you’re out at a restaurant, and be able to eat that way. There are lots of different handles and approaches to being able to drink out of cups using two hands instead of one hand.

We have a lot of adaptive splints and utensils. The universal cuff is the classic—where if somebody doesn’t have hand function, we have a cuff, we put it on their hand, and the fork goes in the little cuff and they feed themselves. We use long straws for people who can’t bring a soda can to their mouth. We use plates with rims on them when there’s problems with scooping. We also adapt the food. For example, if somebody enjoys soup, we put some crackers in and we make it thicker so it’s easier for them to eat.