This section is from the book "Practical Dietetics With Special Reference To Diet In Disease", by William Gilman Thompson. Also available from Amazon: Practical Dietetics with Special Reference to Diet in Disease.
In feeding helpless patients with fluids, if the head is to be raised, it should be done by placing the hand beneath the pillow and lifting it gently. This affords much better support, and is more comfortable for the patient, for the head is less likely to be bent so far forward as to interfere with swallowing. If a tumbler is used, it should always be small and not more than two thirds filled. An average breakfast-cup holds eight fluid ounces, and an average tea-cup six fluid ounces. A thirsty patient derives more satisfaction from draining a small glass than from sipping from a large one which he is not allowed to empty. The feeble patient should not be allowed to swallow during inspiration, and the nurse should be careful that each mouthful is swallowed before another is given, to prevent serious coughing.
When a glass tube is used for feeding, it should have a flattened end to hold in the mouth, and should be bent near the centre at a slight angle, so that it is unnecessary to flex the patient's head. If feeding-cups with spouts are employed, they should be of glass, so that the nurse can see how much the patient is taking; otherwise fluid is apt to be poured into the mouth in too large a quantity. As a rule, the bent tube is decidedly better to use when the patient has any power of suction at all. Even when he has not, the glass may be raised by the nurse, so that the fluid flows into the mouth without effort. The cup and tube should always be prevented from dripping.
Patients need only be aroused from sleep to take nourishment in serious cases. Usually the ease with which a patient drops asleep should determine the necessity for awakening him. Sleep is often more beneficial even than food, but there are cases in which a patient awakens to take a sip of milk or a few mouthfuls of food, and will immediately drop off to sleep again. Such patients may be aroused for food every two hours if there is need, as there may be in typhoid fever. Some patients are annoyed by awakening at three or four o'clock in the morning, not being able to sleep again. Food of some sort should always be kept on hand during the night, and drinking a cup of hot bouillon or cocoa will often enable them to fall asleep again for two or three hours.
The patient's comfort is very dependent upon keeping a clean mouth, as indeed are his appetite and taste. A helpless patient whose mouth and lips are allowed to become parched and sour will refuse nourishment which he might otherwise gladly take. The mouth should be rinsed each time after eating with pure water, hydrogen peroxid, or diluted Listerine (two tea-spoonfuls to the tumbler of water), or borax water of similar strength. It is much easier to keep the mouth clean in this manner than to disinfect it after it has been neglected. Milk especially lingers on the mucous surface, and, fermenting there, destroys the sense of taste and develops germs that interfere with digestion. When the patient cannot rinse his own mouth, it must be frequently cleansed by the nurse with a swab of fresh cotton fastened on a small flexible stick, such as a piece of splint, and moistened with the mouth wash. The best tongue scraper is made with a piece of whalebone, about nine inches long, bent into a loop. If this be applied before the patient's meals, the taste nerves of the tongue will be uncovered from the accumulated debris which coats them, and the appetite will be improved.
Cracked ice will keep much longer if not allowed to float in melting water. The contact of a metal spoon or dish also melts it sooner, by virtue of the great conductivity of metal.
A piece of cheese cloth, mosquito netting, or linen may be tied over a cup by an elastic band, and the fragments of ice split off with a pin may be laid upon the cloth, so that the melted fluid drains away beneath.