I remember well, having a conversation with Sinead, a care catering chef customer of mine, that whilst in hospital being treated for throat cancer, her Dad was served only 3 things at mealtimes, rice pudding, custard and jelly for the entire time he was there.

It was a clear demonstration that hospital catering staff were ill-equipped to cater for people with Dysphagia, and Sinead was both appalled and heartbroken at the lack of dignity, care and attention shown to her Dad concerning his nutrition because he had swallowing difficulties.

Sinead went back to her care home, a lady on a mission, passionate to improve a) the presentation and b) the variety of pureed meals they served for their ladies and gents, and went on to write a book and to work with us helping to educate other care catering teams.

We regularly get asked by care home managers how to achieve greater meal variety for dysphagia diets so we know this is a genuine challenge you face, and we always love helping you to solve your challenges!

You may like one of our previous articles with recipe ideas we recently wrote:-Puree Food Molds – 5 Nutritious Puree Food Recipes

As people with dysphagia have a higher risk of malnutrition, it is absolutely vital that they get a good variety of tasty, nutritious and visually appealing meals and, more importantly, also that they do not feel marginalised or treated differently at mealtimes.

With a few notable exceptions, with the right tools at your fingertips most foods are easily pureed.

So, it is more the case that we need to work on our pureed food mindsets, get creative and remember that:

1. Pureed food is still food. It doesn’t have to be bland and tasteless. Some of the world’s great chefs use pureeing.
2. People living with dysphagia have the same needs for balanced meals as everyone else does. And their taste buds are still active too!

What is preventing you from serving the same meals to all of the people you support, regardless of their needs and creating a fantastic inclusive mealtime experience for all?

Having the right tools to create dysphagia diets is key as the finished dishes must meet the international IDDSI standards that follow clinical recommendations to reduce risk.

So having a good quality food processor or blender is essential to finely process foods to a completely smooth consistency.

Food thickeners are used to thicken liquids and foods to various consistencies. They help to slow the transit of foods and fluids to allow more time to coordinate the swallowing process safely.to create the exact required safe consistency. This prevents foods and fluids from entering the lungs and causing serious complications.

NB: Always refer to your Speech and Language Therapist for correct clinical advice for the people you support with dysphagia

It’s also really important to remember that people often refuse to eat what they can’t recognise, and one of the key challenges with pureed food is how to recreate the original shapes of meals.

Here, food moulds can be incorporated to create the original shapes of pureed food, ie a piece of chicken, a portion of peas, sausages and more. They are available in 12 varieties by food type, as listed below, however they are extremely versatile to help create many different meals as we explain.

NB: Food thickener is added to the food prior to placing in the mould to help retain the food shape and create the appealing finish

Handy tip

When I talk to care home chefs who have mastered the use of food moulds they also tell me that they have helped to significantly reduce their food waste, as any leftover foods they have, they now just puree down, fill their moulds and freeze portions for another day. Quick, simple, done!

Here are a few meal suggestions:

Breakfast:

• If the people you support love eggs, prepare pureed eggs either scrambled or poached on toast
• Try a cooked breakfast with sausage, scrambled eggs and baked beans
• Prepared with care, cooked pureed porridge is a hearty and satisfying option with options to add apple and cinnamon for a tasty twist.
• Mashed bananas can be created using the sausage mould
• If you’re feeling adventurous, what about a hot bacon sandwich or baked beans on toast?

Lunch: Midday presents another opportunity for tasty, nutritious meals, here are just some examples of what you can produce:

• Build a puree roast dinner featuring favourite sliced meat( in sliced meat mould), mashed potatoes( in rice mould) and one or two veggie portions (carrot, broccoli, green beans or cauilflower)
• Steak and chips can be easily presented, (providing the meat is tenderised) using the chicken breast and green beans moulds, or substitute steak for fish (fish fillet mould) if you prefer
• Many casserole dishes and stews can be processed and presented. Try a pork and apple casserole with mash and veg using the cubed meat mould, rice (for mash) and any veg.
• Create vegetarian options including a Mediterranean vegetable pasta dish (using pasta mould) with vegetable portions, or a mac and cheese with the pasta mould

Lighter meals and snacks:

Again, think about what you’d like on a plate. Very often, a pureed version can be just moments away. Just because someone is on a pureed diet doesn’t mean they can’t also enjoy sandwiches, biscuits and cakes. Using a soaking solution process, your people can get to enjoy their favourite snacks and treats too!

If you would like more helpful hints and tips on managing dysphagia, then please download our free Dignified Dining Guide here

Testimonial

"My daughter is 12yo. She has diagnoses of Down's syndrome, oral dysphagia, autism, sensory processing disorder and food intolerances. I have only been able to give her pureed or mashed food which she was not particularly interested in. She is assisted while eating. The first time she saw her 'food moulded' dinner she shouted, "carrots!". The second time she wanted to know what every bit of food was on her plate. This time I had used parsnips in the carrot mould. "What's that, what's that?", she said as she used a fork to scoop up individual pieces of dinner into her mouth with glee. I have neither the time, energy nor interest for 'faffing' about these days so the moulds are extremely practical. Easy to clean, easy to fill with food, easy to freeze and the frozen food just pops out. I have made batches of vegetables, meat and fruit, popped them out of the moulds and stored them in another container in the freezer to use later. One can use the broccoli mould for cauliflower and sprouts. The pumpkin mould for turnip and sweet potato and as I mentioned earlier parsnip in the carrot mould. But what is most important is that my daughter is beginning to enjoy her meal times and showing greater independence .... because of the moulded food. From my experience, the silicon food moulds have been a success.

Mrs D. Drewery