Feeding and Swallowing Care Does Not End with the "Mouth Alone": The Perspective of "Awakening the Whole Body"

When people in the nursing care field hear the term "feeding and swallowing care," what most people think of first is:

・Oral care
・Swallowing exercises
・Ice massage

I think it's around these things.

Of course, all of these are important.
In fact, you could say they are the absolute basics.

However, when you have been involved with elderly people in the field for a long time, you encounter a certain sense of discomfort.

"Even if you work hard on mouth care alone, there are people who still cannot swallow well."

Conversely,

people whose bodies are well-aligned also show changes in their mouth movements.

Once you start having this feeling, the way you view feeding and swallowing care begins to change.

The human body does not operate so conveniently as "mouth-only independent operation."
Rather, we eat with our whole bodies.

Even though civilization has evolved, humanity still wants to separate "swallowing" as a "mouth problem."
The human body is not a robot with replaceable parts.

The idea of "waking up the body before eating"

At my previous workplace, as an approach before meals,

"First, wake up the body"

was a perspective I valued.

What I mean by "waking up" here is not simply getting out of bed.

・Muscle tension
・Posture
・Breathing
・Arousal
・Trunk function

It means adjusting these whole-body conditions.

Elderly people's bodies become increasingly stiff due to long periods of lying down, poor posture, pain, and tension.

The areas that tend to get stiff in particular are:

・Around the neck
・Around the shoulders
・Pectoral muscles
・Back muscles

These areas.

When these become stiff, maintaining posture becomes difficult.
Breathing also becomes shallow.
Neck movement also worsens.

Naturally, this also affects swallowing.

In other words,

before the issue of "not being able to swallow well,"

there is the case of "the body not being in a state to eat in the first place,"

which is common in the field.

Sometimes things change just by "rolling" a rubber ball

At my previous workplace, I used a rubber ball to

・Upper arms
・Around the shoulders
・Back muscles
・Pectoral muscles

and lightly stimulate them.

Rather than a massage, it was more like just "rolling" it.

I don't press hard.
It's more of a gentle sensation, as if teaching the body, "It's okay to relax."

Then, strangely enough,

・Facial expressions soften
・Breathing becomes deeper
・Arousal increases in people who looked sleepy

I have seen such changes.

Of course, it doesn't have a dramatic effect on everyone.

However, at least as a feeling in the field,

"When muscle tension in the body drops, the ability to eat also changes."

I have really felt this.

The reason why "facial rollers" appear in nursing care settings

When the word "facial roller" comes up in a nursing care setting, it suddenly feels like a TV shopping program.

But in reality, it is surprisingly logical.

Elderly people are prone to:

・Lack of facial expression
・Stiffness around the mouth
・Decreased saliva secretion

In particular, when

・Lips

・Cheeks
・Around the jaw
become stiff, it affects:

・Taking in food

・Chewing
・Producing saliva
These movements are also affected.

So, I gently stimulate the area around the face.

Not for beauty purposes, but

to "loosen the facial muscles."

When you lightly stimulate the cheeks and around the mouth,

・The mouth becomes easier to open

・Facial expressions soften

・Saliva secretion is promoted
I have seen such changes in some people.

Humans are strange; when the face relaxes, the whole body also relaxes a little.

Conversely, people who are always tense also have stiff faces.

That is why stimulating the face as "preparation for eating" makes sense.

The most important thing is "everyday nursing care"

I think this is actually the main point.

No matter how hard you work on oral care or swallowing exercises,

if your everyday nursing care leaves the neck and shoulders stiff, it loses its meaning.

For example,

・Forced pulling up
・Assistance that pulls the arms strongly
・Transfers where the neck is unstable
・Sitting with the body twisted

These types of assistance create strong muscle tension in the person.

As a result,

we ourselves can create a "body that is difficult to eat with."

Therefore, the concept of no-lifting care is also connected to feeding and swallowing.

Do not lift, but utilize the body's movements.

Do not pull forcibly.

Support them so they can move comfortably.

Then, it also leads to:

・Reduction of tension around the neck

・Stabilization of breathing
・Improvement in posture maintenance
In other words,

"meal assistance is not completed only during mealtime."

Transfers too.
Positioning too.
Getting out of bed too.
All everyday interactions affect swallowing.

"Eating" is a whole-body exercise.

When we talk about feeding and swallowing care, we inevitably look only at the inside of the mouth.

But in reality,

・Is the body awake?
・Is breathing regulated?
・Is muscle tension too high?
・Is posture stable?

These "whole-body conditions" are significantly related.

That is why I think the important thing is the perspective of

"awakening the whole body before eating."

Instead of just caring for the mouth,

align the entire body.

That is also one part of feeding and swallowing care.

And in nursing care, there are really many things like this where "things that seem unrelated at first glance are actually all connected."

That is why it is interesting, and difficult.
The human body is too delicate despite having no instruction manual. It is truly a troublesome masterpiece.