A Guide to which Dysphagia Cups are suitable for IDDSI Thickened Drink Levels

Managing the ladies and gents you support with Dysphagia and ensuring that they maximise on the correct levels of hydration represents a huge challenge to care managers and their teams, given that these residents are at high risk of being deficient due to finding it difficult to tolerate large volumes of fluids.

And Dysphagia is known to affect between 53%-74% of nursing home residents, occuring in people who have a Dementia, stroke, Motor Neurone disease and other neurological conditions.

The key to maintaining hydration for people with Dysphagia is to promote safe swallowing and to ensure that the fluids are of the appropriate texture and thickness.

Here are some top tips on safer swallowing for improved hydration

1. Ensure your resident is always sitting upright at 90 degrees when drinking.

2. Do not give them drinks when slouched or lying down

3. Encourage small sips of fluid and discourage gulping

4. Make sure they have swallowed a drink before taking more in

5. Prevent people from using drinks to wash down food.

Other strategies to help improve hydration include:

• Thickening fluids for safer swallowing

• Correct positioning

• Drinking smaller quantities with each sip:

• Investing in specialist Dysphagia drinking cups.

Today we want to focus specialist Dysphagia drinking cups.

We’ve heard time and time again about the profound impact that a well-chosen dysphagia cup can have on an individual's journey towards safer and more enjoyable hydration.

That ‘it's not just a cup’; it's a vital tool for fostering independence, ensuring proper hydration, and instilling a sense of dignity and there’s a vital connection between dysphagia cups and the IDDSI framework, a relationship that significantly influences the comfort and success of a persons’ swallowing experiences.

We were recently asked by a fellow care professional Christine Elseley

Which dysphagia cups are suitable to be used with thickened drinks?

So our lovely Donna has been on a mission to answer this question, with help from our cup manufacturers, to help empower our clients with the tools that promote both safety and dignity.

Donna has produced a really helpful table, see below, featuring all the dysphagia cups we can provide including the features, benefits, and suitability of each different cup to the specific demands of each IDDSI, (International Dysphagia Diet Standardisation Initiative) thickened drinks level. 

Together we hope we can help to unravel the symbiotic relationship between dysphagia cups and IDDSI thickened drinks levels, forging a path towards enhanced well-being and improved quality of life for those navigating the challenges of dysphagia.

Cup		Level 1 – Slightly Thick	Level 2 – Mildly Thick	Level 3 – Moderately Thick	Level 4 – Extremely Thick (Spoon only)
Ornamin 1 handled Mug with Internal Cone Designed to quench thirst of those with limited mobility, this product comes in a variety of colours and is easy to use. The insulated cup looks like a normal thermos cup but in combination with a drinking lid can be used for people with swallowing disorders/dysphagia. https://hcsuk.co.uk/product/keep-warm-mug-with-internal-cone-200ml-207/		Yes – with spouts/discreet drinking lid	Yes – without spout or lid	No	No
Ornamin 2 handled Mug with Internal Cone Designed to quench thirst of those with limited mobility, this product comes in a variety of colours and is easy to use. The insulated cup looks like a normal thermos cup but in combination with a drinking lid can be used for people with swallowing disorders/dysphagia. https://hcsuk.co.uk/product/ornamin-two-handled-mug-with-internal-cone-200ml-815/		Yes – with spouts/discreet drinking lid	Yes – without spout or lid	Yes – without spout or lid	No
Kapitex Dysphagia Cup The dysphagia cup is designed to make swallowing drinks easier and safer for individuals with dysphagia through the unique shape which enables drinking while tucking the chin toward the chest and providing sufficient nose clearance to empty the cup without tilting the head back. https://hcsuk.co.uk/product/dysphagia-cup-200ml-x1-osfsa500/		Yes	Yes	Yes	No
Kapitex Kapi-Cup Kapi-Cups have a cut out on the non-drinking side so that they can be tilted without interference by the nose. This allows the drinker to avoid tilting the head back, thus minimising the chance of liquid entering the respiratory tubes and causing choking. Available in Small, Medium or Large sizes with a choice of Single or Double Handled Holders.		Yes	Yes	No	No
Kapitex Sure Grip Mug This feeding cup is designed with an angled spout to facilitate ease of use. Grooves in the cup ensure a better grip and the unique lid enables flow control and reduces spills if the cup is tipped over.		Yes	Yes – with Large/Wide spout	Yes – with Large/Wide spout	No
Kapitex Drink Rite Cup/Beaker Drink-Rite provides a controlled flow of fluid into the mouth. This is important, as some users will not be able to drink and swallow safely if there is too much fluid delivered. This often occurs after stroke or other head and neck issues. Available with or without handles and both come with 2 different inserts, 5cc & 10cc. https://hcsuk.co.uk/product/drink-rite-5cc-insert-10cc-insert-x1-osfsa530/		Yes	No	No	No

Please note: These suitability levels are as quoted by the manufacturer of each mug/cup and are as a guide only. We always recommend that you check first with a Speech and Language Therapist for suitability and safety before purchasing.

Levels as described using the IDDSI Framework

Level 1 – Slightly Thick

• Thicker than water

• Requires a little more effort to drink than thin liquids

• Flows through a straw, syringe, teat/nipple

Level 2 – Mildly Thick

• Flows off a spoon

• Sippable, pours quickly from a spoon, but slower than thin drinks

• Mild effort is required to drink this thickness through standard bore straw

Level 3 – Moderately Thick

• Can be drunk from a cup

• Moderate effort is required to suck through a standard bore or wide

• Bore straw (wide bore straw = 0.275 inch or 6.9 mm)

• Cannot be piped, layered or molded on a plate because it will not retain its shape

• Cannot be eaten with a fork because it drips slowly in dollops through the prongs

• Can be eaten with a spoon

• No oral processing or chewing required – can be swallowed directly

• Smooth texture with no ‘bits’

We’ve also created a new page on our website, dedicated to Managing Dysphagia and providing a range of #fitforpurpose product solutions to help you solve your challenges and improve quality of life and wellbeing for people living with dysphagia including:

• Safe drinking solutions

• Solutions to prevent choking

• Improving quality and appearance of pureed meals

• Solutions to keeping meals warmer for longer

• Solutions to provide safer oral care

• Solutions to stimulate taste and smell

You can view it here.

Here's a link to another article which you may find of interest.