Dignified Dining

Tools and techniques can make mealtime manageable

by Barbara and Jim Twardowski on May 1, 2007 - 2:15pm

QUEST Vol. 14, No. 3
Matt and Terra Messmer of Tucson, Ariz., enjoy an evening at a favorite restaurant. Photo by Rick Peterson

I love the scene in the movie “Pretty Woman” in which Julia Roberts attends a business dinner in a posh restaurant. She’s served escargot and attempts to grasp one with a snail tong. With a snap, the appetizer is sent sailing across the room and is deftly caught by a waiter.

Although Julia’s struggle with her meal is humorous, I’m not as quick to laugh when my own lack of dexterity is the center of attention. Because I have Charcot-Marie-Tooth disease, my hands are curled and weak. When I eat out, my husband often cuts my steak or peels my shrimp.

See an expert

If you have weak hands and difficulties at mealtime, you may need to see a physical therapist, occupational therapist or certified hand therapist.

Marianne Mortera is an assistant professor of clinical occupational therapy at Columbia University Medical Center in New York and an editor of the American Occupational Therapy Association’s Physical Disabilities Special Interest Section Quarterly. She explains that a therapist will assess your gross, sensory and fine motor functions; strength; range-of-motion; severity of weakness; manipulation and more.

A therapist will take a detailed medical history. Typical questions might include, “Are you feeling clumsy or dropping things?” or “Are you having any difficulty cutting your food?” or “Have you changed what you eat or prepare because of your hands? For example, it may be easier to eat a bowl of cereal rather than make a sandwich.”

Behavioral changes such as these can indicate you’re compensating for your weak hands. Perhaps you’ve changed habits and didn’t consciously realize your hand weakness was progressing.

Therapists may test swelling, sensation and strength where appropriate. Hand therapists assess any problems in functional use of the hands, starting with general weakness, and narrowing down to specific activities of living, such as starting the car, eating or opening a jar.

“Evaluating hand weakness is more than opening and closing the fingers,” Mortera said. “Of all the things that the human body does, using our hands is the most complex activity. From buttoning a collar to gently placing a contact lens on the eye, hands are unique.”

A person may have weak hands and still be able to grasp. Or perhaps the pincher grasp — the ability to pick a straight pin up from the floor — isn’t functional. There’s even a cylindrical grasp — the one that lets you wrap your fingers around a tall glass of lemonade and bring it to your lips.


With a therapist’s assistance, you can find a variety of modified and adaptive tools for use in the kitchen and dining room. Some examples include built-up handled silverware for weak or incomplete grasp, rocker knives, special cutting boards, nonskid placemats to prevent food from sliding across the table, and even stirring and pouring assists.

“Hand therapists also often make custom orthoses or splints to stabilize or assist weak muscles or help put the hand in functional positions,” said Christine Muhleman, 2006 president of the American Society of Hand Therapists.

“A few more products are out there every year, but many are custom-built by therapists and may never go into production,” Muhleman said. “I personally like to use pieces of plumbing insulation tubing, wrapped around different handles (from knives to toothbrushes) to enlarge them. It’s a quick, easy, washable and inexpensive modification.”

Muhleman added, ”Commercially available products such as Coban and Vetwrap (brand names) may also be used to modify handles by wrapping them to build them up and customize the shape. There are also materials that can be heated to soften and then mold for a custom shape.”

And sometimes, necessity is the mother of invention. When ALS left Ron Edwards so weak he could no longer feed himself, his wife, Linda, searched for a device to help her husband. She couldn’t find one on the market, so she built an assistive device consisting of an armrest, a ball-and-socket joint and a stable base.

The contoured armrest comfortably supports a user’s forearm while the ball joint enables it to pivot and rotate. The couple named the device the Arm Thing. Encouraged by their medical team, they’ve begun manufacturing the Arm Thing and marketing it to the public.

Coping strategies

Living with a disability means adapting to change. If you’re dining in a restaurant, you may want to bring adaptive utensils, or ask the waiter to have your steak cut in the kitchen, or get assistance from your dining partner. Muhleman suggests using straws in beverages to minimize lifting and moving glassware.

What you eat is a personal choice. If I don’t want someone helping me cut my meal when dining out, I order the fish.

Eating can be messy — that’s why I carry a stain remover pen in my purse for embarrassing spills. I tend to drop things rather easily, so at home, I drink out of plastic cups and use lightweight dishes.

I used to break glass coffeepots until I bought a Cuisinart Coffee on Demand Coffeemaker, which didn’t come with a pot. Instead, I put a coffee cup under the dispenser and push a button — like what you’d find at a convenience store.

Every kitchen needs an easy-to-use can opener. I’ve used the Hamilton Beach Classic Chrome Heavyweight Can Opener for two years. It’s taller than an average can opener, and it doesn’t tip over. Also, the “cutting unit” is removable for easy washing.

If your hands shake, like mine, a cool-touch toaster — mine is an Oster — prevents burns. And a refrigerator with a water/ice dispenser on the outside is worth the extra cost.

Night on the town

The next time my husband and I go to dinner, I’ll choose a romantic restaurant that’s dimly lit — preferably with candles. We’ll sit in a secluded corner, and when Jim leans in to assist me with my dinner, the other patrons will simply assume we’re enjoying an intimate moment.

Thanks to MDA National Vice President Bob McMahon, CEO of Metro Restaurants of Tucson, for assistance with these photos.

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