Expert: Carol Schlitt - 2/23/2007

Question
Ok here is my issue.  I work in a group home for 4 clients with profound MR.  One of my clients is extremely food obsessive and he is constantly rooting through the fridge and cupboards and eating things like jelly and peanut butter either with his fingers or a spoon with many redips. Now he also has very poor personal hygiene,  We are always catching him touching personal parts of his body.  we direct handwashing continually but I know there are instances that he is coming into contact with fecal matter and then direct contact with foods such as jelly, peanutbutter, open bags of chips ect.  Now when I find him digging into the jelly jar with his fingers like this I throw the whole jar out immediately.  I was recently reprimanded about this, I was told that I should put his name on the said object and then it would be his own personal jar of jelly or whatever.  The question is is the food contaminated and a danger to himself then?  The other concern is that not all staff are so diligent and I am sure somehow the other 3 clients would ingest some of this food eventually. i Would love an opinion on this?  Am I being a crazy fool or just careful.

Suzan

Answer
Hi Suzan,

First, I want to commend you for the job your are doing working in a group home.  This is a challenging position that often goes unrecognized for the dedication and compassion you are showing to those in your care. A big "THANK YOU" from one who appreciates what you do.

Now...on to the question at hand.  

You ask is food such as jelly, peanut butter, chips contaminated and a danger to the person and others who may consume the food.

The answer is "YES."  One of the most common ways to spread food borne illness is through the contamination of ready-to-eat food products. This is one of the main transmission routes for the spread of many pathogens including Hepatitis A -- that is the fecal/oral route. Most diarrhea without other symptoms (fever, nausea, vomiting) is caused by the innocent spread of bacteria or viruses through contaminated hands. And yes, one can spread the pathogen right back to oneself.

Perhaps the answer is to keep the food away from the clients so they can not "rummage" and cause contamination. Is it possible to keep the food locked away from the clients and only made available to them during meals and snack times?  If this is not possible, I would suggest the next best option would be to have the client in question his own personal "food stash" that is only available to him. That way he is only infecting himself and not others.

I feel for you and your situation. You are wanting to be very careful about your charges health and ideally all potential contamination episodes with this client should be thrown out. However, we live in the real world where risks need to be weighed against cost. Your administrators obviously weigh in on the cost side.

Your job now is to do the best you can do during your time with your clients to ensure proper handwashing and the avoidance of direct hand contact with foods. I would follow my supervisors instructions as to how to handle this situation with the knowledge that potentially this one client can be infecting not only himself but others with food borne illness.  

I hope this has helped, Suzan.  Please let me know if I can be of further assistance.

Carol