People with advanced rheumatoid arthritis often experience deformities in their upper body joints that make it difficult for them to complete basic daily living tasks. Eating is one of these basic tasks that can be impaired by upper body arthritic deformities. If you are one of these people, meals may already be a frustrating time of day for you. Here are some helpful tips to increase your independence during mealtimes.

First, move your arms and hands and assess what motions you are able to use. Maybe you can't curl your fingers around a spoon handle anymore, but maybe you can pinch it between your thumb and the side of your hand. Can you move your shoulder? Can you bend your elbow? Can you turn your forearm to make your palm face the ceiling? Move each joint and look at what kind of movement you have or don't have. This will help you determine how you should adapt your place setting during meals.

Next, eat a meal and pay attention to what the main problems are as you eat. Decide if the problem that is really bothering you is a simple one to fix. Maybe the whole issue is that your food slides off your plate and you are unable to stop it. Maybe you can't cut meat. Maybe you can get the food on your spoon or fork, but you can't turn your wrist enough to bring it to your mouth without spilling it. These are just samples of problems that might occur. You might have these or others, or combinations. Try to determine what is causing the problem and how easy that problem is to fix. Having another person help you with this might be a good idea, as another set of eyes may see an issue with a plate, glass, or utensil that you don't notice.

After assessing the situation, you are ready to decide what adaptations you might need during meals. Some adaptations are simple and some are specialized. Here are some examples of simple problems and adaptations to correct them:

Problem: Your plate slides on the table and you can't stop it.
Solution: Place a wet washcloth under it or purchase nonskid shelf liner at your local discount store and place a piece of this under your plate.

Problem: You are unable to tip your glass or cup to drink.
Solution: Use a short straw to drink liquids.

Problem: You are able to hang on to your silverware, but it just does not feel secure or you drop it sometimes.
Solution: Purchase plastic handled picnic ware or similar silverware that has slightly larger handles. These utensils are easier to hang on to than traditional silverware, but are not specialized and are readily available at your local discount store.

If your problems at mealtime are more complicated than this, you may need adapted utensils or dishes. Thanks to the internet, these are also readily available. There are many different types of adapted utensils and the selection can be confusing at times. Here are some sample problems and solutions that involve adapted utensils and dishes:

Problem: You are unable to close your fingers around small handled utensils.
Solution: Purchase large handled adapted utensils or purchase foam tubing to place around the handles of the utensils you have. Foam tubing is less expensive, but wears out faster. Large handled utensils cost more, but are more sanitary and last longer.

Problem: You can't cut your meat.
Solution: Purchase a rocker knife. This type of knife is specially designed to allow you to use a rocking motion to cut, rather than the traditional sawing motion.

Problem: Your food slides off your plate and you cannot stop it.
Solution: Purchase a plate guard or a plate with a lip on it. Both of these items are designed to stop food from sliding or rolling off of a plate.

Problem: You have severe ulnar drift and you cannot hang on to anything.
Solution: Purchase a universal cuff. This is a simple elastic band that slides over the palm of your hand. The band has a pocket in it that will hold the handle of a spoon or fork, allowing you to hold the utensil yourself.

There are many more examples of adaptive utensils available. Adaptive utensils and dishes have been designed to overcome just about any obstacle to eating. Many of these devices are available on the internet at Arthritis Supplies, so please visit their website at http://www.arthritissupplies.com to browse their selection of adaptive utensils and dishes.

If determining what adaptations you need for eating is too overwhelming for you, an occupational therapist can help you decide. You do not need to see an OT for months to do this. Two or three sessions to assess your eating and determine which adaptive devices will work for you should suffice. Check your insurance plan to see if occupational therapy is covered and where an occupational therapist is located in your area. For more information on occupational therapy, please visit The American Occupational Therapy Association at http://www.aota.org/Consumers.aspx

Eating does not have to be a frustrating, humiliating experience. Adapting your utensils and dishes can help you regain your independence and your dignity during meals, so take a look at your mealtime set up and take control of it today.