Texture Modified Foods – Eating For Pleasure and Health
By Mandy Davies, Head of Nutrition & Dietetics at Elior UK (www.elior.co.uk)
Let me tell you about dysphagia – Imagine being too scared to eat. Imagine not being able to eat your favourite foods. It’s sim- ply unimaginable for most of us, yet for many care home residents it’s very real. Up to 75% live with dysphagia (swallowing difficulties) leaving them unable to eat everyday foods in an everyday way.
Various health events can lead to dysphagia, such as stroke, cancers including head and neck cancer, learning disabilities and progressive neurological disorders. Whilst dysphagia can affect all ages, its occurrence disproportionally affects the ‘older adult’, hence the prevalence in the care home setting.
Dysphagia can affect swallowing food or drinks, chewing, sucking, controlling saliva, taking medication, or protecting the airway from choking. Having swallowing difficulties greatly impacts on an individual’s quality of life. People who do not receive a diet that meets their individual needs are vulnerable to malnutrition, dehydration and weight loss, as well as psychological symptoms such as anxiety and depression.
Why Texture Modified Foods? – The swallowing process is made up of 3 stages (oral, pharyngeal and oesophageal). Safe and successful swallowing depends on each stage of the swallowing process being completed and happening at the right time. In a person with dysphagia, any or all the swallowing stages may be delayed. This increases the risk of choking and aspiration, which can be fatal. Altering the consistency of food and liquids (TMF) provides individuals with a better opportunity to swallow food and drink safely.
NHS Improvements called for all NHS staff to use clearly categorised food textures, as published by the International Dysphagia Diet Standardisation Initiative (IDDSI). This was enforced internationally from March 2019 to ensure patients of all ages and all cultures, are fed safely and correctly according to their individual needs across all care settings. TMF must be prescribed by a Speech & Language Therapist.
The Food: TMF is not just pureed food and it’s certainly more than just mashed potato. It is about modifying the consistency and texture of foods and drinks to safely maintain oral nutrition wherever possible. It is about offering texture modified meals that are consistent in texture using a variety of safe foods. It is about enabling people living with dysphagia to dine with dignity by offering tasty, nutritious and recognisable meals. It is about inclusion.
The People: Supporting people living with dysphagia is everyone’s responsibility. It is vital that IDDSI descriptors are used by all health professionals in the UK, and that food is cooked and prepared to the required consistency – with love!
Chef’s preparing TMF should undergo robust training and have competencies assessed at regular intervals. Enhanced training, including piping skills is a must for an integrous approach. Food service is just as important, and the social opportunities should be not be overshadowed by medicalisation. We’re all human and mealtimes should be enjoyed by all.
Mandy Davies, Head of Nutrition & Dietetics, joined the Elior UK family last year. Following on from Caterplus’ award for their Dining with Dignity Programme in 2020 she is on a mission to drive inclusivity and promote great food choices for everyone. When she’s not working, you can find her walking, trail running or entertaining friends.