Bon Appétit! Enhancing the enjoyment of texture modified food Presented by Shannon Farmer, Corine Poirier & Christine Tuan Selkirk Mental Health Centre The Dining Experience Eating is the most social of all  activities of daily living Eating is a fundamental pleasure  in life The ability to eat independently  is the first activity of daily living that an individual masters and it is the last to be lost in dementia The Dining Experience Imagine never again  experiencing crunchy, crackling, chewy or crispy foods Imagine being denied these  sensations because you might choke or aspirate anything but the blandest puree Pureed Diets The mere mention of a pureed diet  evokes the image of frail edentulous weak or debilitated patients The usual appearance of a pureed  diet serves to perpetuate ideas of sickness and disability Pureed foods described as uniform in  appearance, unappetizing appeal, difficulty deciphering one food item from another Dysphagia Dysphagia = Difficulty with  swallowing Common medical conditions  associated with swallowing disorders include: dementia, acquired brain injury, progressive neuromuscular disorders (Parkinson's), stroke Texture modified diets are an integral  part of dysphagia therapy Outline of Presentation Dysphagia management at  SMHC Texture modified diets  Perceptions of pureed textures  Bon Appétit Group  Food/dining enhancement  strategies Tips and practical application  Dysphagia Management SMHC’s Dysphagia Team  Developed to maintain evidenced-  based standards of care for safe feeding and swallowing Policies and procedures  Standardized screening, assessment and  management Staff training  Provides resources for staff and family  Newsletter, pamphlets  Continuous quality improvement  Texture Modified Diets Texture modification is  extremely common (15-41% of patients in LTC settings) High incidence of malnutrition in  institutionalized elderly Stahlman, L.B., Garcia, J.G., Hakel, M., Chambers, E. (2000). Comparison Ratings of Pureed versus Molded Fruits: Preliminary Results. Dysphagia, 15, 2-5. Texture Modified Diets & Nutrition Consequences associated with  malnutrition can be life- threatening resulting in: Reduced muscle strength and mass  Impaired immune function  Dehydration  Constipation  Chronic infections  Decline in cognitive and physical function  Texture Modified Diets & Nutrition Malnutrition in hospitalized elderly can  be explained through: Diet changes  ↓ privacy (e.g. rituals, choices, meal time)  ↓ consumption of nutrient rich foods  (oral/swallowing) Medical diagnoses (e.g. dementia, stroke)  Mental health issues  Medications  Impaired physical function  Sensory changes associated with aging  Blaise, M. (2009). Mealtime Experiences of Hospitalized Older Patients Requiring a Puree Consistency Diet. University of Montreal, Montreal, QC.