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Anna, welcome to the site! The first place to find information is by clicking on ‘Care Topics’ at the top right of the screen. You get an alphabetic list, so click on S for Swallowing and scroll down to find many old question and discussion threads, plus experts' articles on the subject. There are several sorts of problems, so this will also help you be clearer about what sort of Swallowing Problem this is. I’ve dealt with this, but there's no point in telling you about it as it's probably not your particular type. Best wishes, Margaret
The first thing is to figure out what she can eat. Does it need to be minced or pureed? Does she have a problem with thin liquids? It is possible that thin liquids may need to be thickened. Has this been brought to her doctors attention? Thickening thin liquids can go from "nectar" thick to pudding thick and everything in between. Is she choking? This can cause aspiration pneumonia and that can happen in a short time. Or is she "pocketing" foods? This is where a person will chew food then keep it in their cheeks. An assessment should be done to determine what the problem is and the safe way to present food. For about the last year of my Husbands life his meals were all pureed. A lot of soup (thickened with extra vegetables rather than a product like Thick It) And a lot of cereals like cream of wheat, cream of rice and I would also do oatmeal that I would grind before cooking so I guess you would call that cream of oats.
You do not mention a diagnosis but this is common with dementia. If this is the case with your mom... Sit with her when she eats. I would encourage a sip of a liquid with each bite. I used to then rub my husbands cheek to encourage him to swallow and to push any food that might be in the cheeks out. After a meal or snack I would then take a swab and run it around the inside of the cheeks and under the tongue. (Never put your fingers in the mouth)
My husband had to have all his drinks thickened with the product Thick It, and I had to pureed all his foods after he survived aspiration pneumonia. You can pureed any meats, vegetables, fruits etc. so that shouldn't be an issue at all, and you don't need any special recipes. Whatever your mother normally liked to eat, just pureed it, and she should be fine. As my husband improved some, I was eventually was able to just give him soft foods like mashed potatoes, macaroni and cheese, hotdogs, fish, soups etc. and I still made sure his meat was cut up small enough and was soft enough for him to eat without choking. Don't make this harder than it needs to be. Just puree what she already likes. Best wishes.
Anna, I think the first issue is to determine the extent of your mother's swallowing challenges. If you know of a good speech pathologist, that would be a start. But typically, they either work for a hospital, or in a practice but not on their own (at least in my area). If you have a PCP in whom you have confidence, ask for suggestions. Hospitals in my area (and I'm sure other areas as well) have someone who can offer guidance and suggestions prior to making a physician selection. You might try to take that route to find a good speech pathologist.
The SP may perform a videoscopic swallowing study, an easy test in which your mother's eating functions would be highlighted, and areas of weakness identified. This would determine which level of dysphagia she may have. That in turn would determine which foods she can safely eat.
All Mom would have to do is sit as positioned near the machine, and swallow little bits of specific test foods (liquids, small crackers) to determine which can safely swallowed, or not. This helps define the level of dysphagia, and the type of food preparation or restriction.
There are dysphagia guidelines, listing at the time 3 levels of dysphagia ((for us, several years ago). Each requires a different level of caution with food. I don't recall each specific level; my charts are somewhere in piles of medical information to be filed.
You could probably find the charts by searching online. One of the best charts as I remember was prepared by a rehab center with a speech pathologist on staff.
There are foods that despite apparent harmlessness should not be eaten. There are also some tricks, such as using applesauce on otherwise verboten foods such as toast or cookies.
E.g., personally, I found pureeing meats worked better when I added gravy, but sometimes it too had to be thinned.
I hope you're able to find solutions to help both you and your mother.
5. One of the sites includes a valuable ""Postural/Position Techniques" section" but I lost the URL; if I can find it, I 'll post later.
6. Excellent source with detailed information:
https://iddsi.org/
7. A few months ago when I'd search, I would be able to find specific charts, just charts and foods. It appears that dysphagia has become more prominent in the medical field, and assessments now are oriented more toward related issues then just providing menus.
I hope this helps. (I became a bit confused when switching to sites, some of which wouldn't post, so I've gone through this list twice, but I may have missed something. I'll again later though.)
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
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APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
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APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
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If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
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This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Does she have a problem with thin liquids?
It is possible that thin liquids may need to be thickened.
Has this been brought to her doctors attention?
Thickening thin liquids can go from "nectar" thick to pudding thick and everything in between.
Is she choking? This can cause aspiration pneumonia and that can happen in a short time. Or is she "pocketing" foods? This is where a person will chew food then keep it in their cheeks.
An assessment should be done to determine what the problem is and the safe way to present food.
For about the last year of my Husbands life his meals were all pureed. A lot of soup (thickened with extra vegetables rather than a product like Thick It) And a lot of cereals like cream of wheat, cream of rice and I would also do oatmeal that I would grind before cooking so I guess you would call that cream of oats.
You do not mention a diagnosis but this is common with dementia. If this is the case with your mom...
Sit with her when she eats.
I would encourage a sip of a liquid with each bite.
I used to then rub my husbands cheek to encourage him to swallow and to push any food that might be in the cheeks out.
After a meal or snack I would then take a swab and run it around the inside of the cheeks and under the tongue. (Never put your fingers in the mouth)
Whatever your mother normally liked to eat, just pureed it, and she should be fine.
As my husband improved some, I was eventually was able to just give him soft foods like mashed potatoes, macaroni and cheese, hotdogs, fish, soups etc. and I still made sure his meat was cut up small enough and was soft enough for him to eat without choking.
Don't make this harder than it needs to be. Just puree what she already likes. Best wishes.
The SP may perform a videoscopic swallowing study, an easy test in which your mother's eating functions would be highlighted, and areas of weakness identified. This would determine which level of dysphagia she may have. That in turn would determine which foods she can safely eat.
All Mom would have to do is sit as positioned near the machine, and swallow little bits of specific test foods (liquids, small crackers) to determine which can safely swallowed, or not. This helps define the level of dysphagia, and the type of food preparation or restriction.
There are dysphagia guidelines, listing at the time 3 levels of dysphagia ((for us, several years ago). Each requires a different level of caution with food. I don't recall each specific level; my charts are somewhere in piles of medical information to be filed.
You could probably find the charts by searching online. One of the best charts as I remember was prepared by a rehab center with a speech pathologist on staff.
There are foods that despite apparent harmlessness should not be eaten. There are also some tricks, such as using applesauce on otherwise verboten foods such as toast or cookies.
E.g., personally, I found pureeing meats worked better when I added gravy, but sometimes it too had to be thinned.
I hope you're able to find solutions to help both you and your mother.
1. This is a good site for information, and it includes tips given by our speech pathologists on head positioning for maximum security in swallowing:
https://www.asha.org/practice-portal/clinical-topics/adult-dysphagia/#collapse_6
2. Good chart for quick reference:
https://dietitiansondemand.com/a-clinical-dietitians-guide-to-iddsi/
3. This site does provide more information on specific foods in various cateogries:
https://www.gicare.com/gi-health-resources/dysphagia-diet/
4. This site provides the format for which I had been searching, and even includes suggested meals:
https://www.gicare.com/gi-health-resources/dysphagia-diet/
5. One of the sites includes a valuable ""Postural/Position Techniques" section" but I lost the URL; if I can find it, I 'll post later.
6. Excellent source with detailed information:
https://iddsi.org/
7. A few months ago when I'd search, I would be able to find specific charts, just charts and foods. It appears that dysphagia has become more prominent in the medical field, and assessments now are oriented more toward related issues then just providing menus.
I hope this helps. (I became a bit confused when switching to sites, some of which wouldn't post, so I've gone through this list twice, but I may have missed something. I'll again later though.)