[Dysphagia] dysphagia diets

[malindam at samhealth.org (malindam@samhealth.org)]

Our acute care facility uses the designations below for dysphagia diet levels.  The dietary manual includes a list of foods allowed and not allowed in each food group for each diet.  It also includes the general description and rationale for each diet as noted below.  SLP generally inservices dietary about once a year.  I also try to make a point of calling the cook directly to thank her/him when the perfect meal texture tray happens or to report when a patient compliments them on a dysphagia meal.  Since acute care stays are so short I try not to individualize outside of the designated diets if possible.  It makes things a lot easier and more consistent for dietary staff.  The diet order also prompts that a liquid consistency must be designated.  We are also using Water Protocol between meals for appropriate patients.

Dysphagia I Puree:  Consists of blenderized foods which require not chewing and have a pudding like consistency without lumps (i.e. sour cream or mayonnaise texture) and food already in puding form like pudding or mashed potatoes.  Breads/cakes only if softened with slurry.  Extra gravy and sauces are encouraged.  No jello.  Preformed purees are acceptable butmay need extra gravy/sauce.  This differes from a regular diet in that this liquid puress are not acceptable.  Likewise, thich dry purees like dry mashed potatoes are not acceptable.  The key is keeping the texture close to mayonnaise.

Dysphaia I liquified Puree:  Pureed food product at a drinkable consistency.  Consistency should be no thinner than specified for patient's designated liquid consistency.

Dysphagia II Mechanical:  Ground or easily mashed and moist, easy to control in mouth, requires little chewing and forms a cohesive bolus.  At least one pureed or pudding consistency item is desirable on each tray.  Try to make the pudding texture item one that is already in that form, like Katie pudding, custard, apple sauce.  The other items can be in their natural form like macaroni and cheese orvery soft cooked vegetables.  This is a trasition diet with more variation than Dysphagia I Puree but it is still mashable in the mouth and won't break into pieces.  Therefore, food like rice, peas, corn, and lettuce are not acceptable.  Neither are mixed textures like vegetable soup, unless blenderized.  Canned fruit is OK but it should not be in the juice.  Most garnishes are not acceptable.

Dysphagia III Advanced:  Similar to a mechanical soft diet except there are not dry or crunchy itmes like snack food, raw fruit or raw vegetables.  Excessively chewy food are also unacceptable.  All meats must be chopped, ground or deli sliced, soft and moist.  At this level patients may still have difficulty with oral manipulation of solids.  Many aarnishes are not acceptable on the diet.

Malinda Moore, CCC-SLP 

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On
Behalf Of Clarke-Goertz, Kim (PAPHR)
Sent: Thursday, July 07, 2005 11:54 AM
To: 'dysphagia@b9.com'
Subject: [Dysphagia] dysphagia diets


Hi All,
Does anyone want to weigh in on what their facility/agency includes in a
'dysphagia diet'.  Our dietary dept. is considering adding another category
(e.g, minced with no bread or 2 consistency foods) and titling it a
dysphagia diet.  
What have others done and are you happy with the diet system?
Any and all responses would be appreciated.
Kim



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