Posted on Thursday, 19th November, 2020
According to Dr Julie Cichero from the University of Queensland, approximately 30-50% of Aged Care residents in Australia are recognised as having swallowing difficulties due to dysphagia, and are on texture modified diets. The introduction of IDDSI has been a significant update to the way Aged Care chefs manage texture modified meal plans and food preparation.
We interviewed Executive Chef, Loretta Reiken of Dignity in Dining in Queensland to find out what her first-hand experience had been with IDDSI.
We started by asking her about the biggest wins that Aged Care Chefs had had implementing the new texture modification levels and testing methods.
Loretta: Yes, it has, as the IDDSI testing methods available on the IDDSI website and through speech pathology training allow chefs to test food items as per these guidelines. The new IDDSI framework has had an impact on aged care kitchens and aged care organisations have to realise this and support and train chefs to correctly provide safe, nutritious delicious food.
Loretta: Absolutely, all of these factors would improve the dining experience as residents eat with their eyes and to reduce the risk of malnutrition and choking in aged care. But to do so chefs need to ensure that:
- They use fresh ingredients and don’t overcook foods
- Colours are vibrant and appealing
- Texture modification is correct for all IDDSI levels using the testing protocols
- Meals are plated attractively
- There is lots of variety – texture modified doesn’t have to be boring
- They move away from using ice cream scoops
- Does the food taste good? Have you tasted the food!
- Food is naturally fortified with real ingredients to reduce the risk of malnutrition
- Plated meals are not held in hot boxes for an extended length of time
- They serve the meal when the resident is ready
- Care staff have prior knowledge of the menu item
Loretta: The culinary arts go hand in hand with nutrition and speech pathology for the successful IDDSI implementation in aged care kitchen.
For residents with dysphagia, chefs are challenged to provide food by placing nutrition and safety at the centre of the plate.
- Be flexible with the changes, get involved with your speech pathologist
- Be passionate about texture modification and embrace it
- Keep training updated and ensure that staff at all levels are aware of the changes
- Work with the clinical teams and ensure you are all on the same page
Texture modified meals must be considered the ‘norm’ and remove the stigma of ‘yuck, it’s puree I am not going to eat that’.
One way I overcame this issue was to present a texture modified tasting plate for management, care staff and kitchen staff.
This experiment was done over many days with different menu items and after it was noticed that the staff were more engaged when supporting residents.
Texture modified meals created with care are enjoyable, you can taste the different flavours, textures and smell the aroma of the meal.
Meals do have to be created with great care, and artistry to reshape the food into visually pleasing dishes. As residents age and are increasingly restricted in their activities, eating is one of the few daily pleasures they look forward to.
Plating of the meal is important to improve the aesthetic appeal as well as knowing your resident’s preferences, culture and familiar foods.
Using something as simple as food moulds and piping bags can make a huge impact. There are products on the market that thicken and stabilise foods to help hold form.
Naturally fortifying with real food ingredients adds calories to keep residents well-nourished.
Move away from using a bowl plate and try plating on a flat coloured plate as this discourages staff from mixing the food together. Serve gravy and sauces separately, include condiments and have service staff engage residents with their choices.
We would love to know your thoughts and ideas around IDDSI. If you’re an Aged Care Chef from Australia email us at firstname.lastname@example.org or fill this form.