Make meal time social time. The care recipient should sit in a comfortable position and continue to sit up for at least 20 minutes after eating. In order to promote independence, he/she should be encouraged to do as much as they can do on their own.

1. A balanced diet is important - high protein drinks, carbohydrates, fats, fruits and vegetables. Fluids are essential for hydration.

2. Prior to sitting at the table, ascertain possible need to go to bathroom.

3. Always encourage independence at meal time.

4. Position plate for ease, provide flavorful food and handicap utensils.

5. Bites of food should be alternated with sips of liquid (flexible straw is helpful) and small portions are more appealing.

6. If necessary, you can butter bread, pour coffee/tea and cut meats.

7. Notify physician if poor appetite is apparent.

8. Signs of poor nutrition: weakness, sweating, sunken cheeks, diarrhea bouts, dry and reddened eyes, swollen and red patchy tongue, weight loss, trembling and poor muscle tone.

Step-by-step and day-to-day care-giving for a family member or some loved one is not an easy task - it is complex, sometimes stressful, and it must be approached seriously and thoroughly.

Since 1997, I have specialized in Long Term Care Insurance Planning and in 2007, I co-authored The Caregiver's Handbook. The handbook is a simple and realistic guide for caregivers. In addition I am a Community Liaison for Hospice of NJ.