Posted on Tuesday, 20ᵗʰ October, 2020
Less than a year into the International Dysphagia Diet Standardisation implementation, the new texture modification framework took a back seat to COVID-19 as it unfolded around the globe.
As one of the most vulnerable demographics, Aged Care has been particularly challenged with ensuring the health and safety of residents over the last 7 months during the pandemic.
How has IDDSI fared in these extraordinary times and what has been happening with Aged Care kitchens and the ongoing implementation of the new texture levels?
We spoke to Dr Cherie Hugo, dietician with My Nutrition Clinic in Queensland and founder of The Lantern Project, who said that overall, the IDDSI implementation has been received well. For the most part, the issues that have arisen have become a point of innovation and learning rather than problems.
The lack of education around the new texture levels has been one of the broader issues and Dr Hugo has found there is often the need to refer to both the new and old texture levels to ensure understanding between Chefs and clinicians.
Because 2020 has been challenging on so many fronts for Aged Care, some non-essential tasks have been postponed - a focus on IDDSI education and implementation being one of them.
During a recent IHHC webinar, Senior Dietitian Cristal Newman of the South West Hospital and Health Services in Queensland reiterated how important IDDSI education is. She highlighted the importance of educating all food service staff in regional areas where access to speech pathologists and dieticians is limited, to reduce miscommunication and misunderstanding.
Dr Hugo went on to say that in kitchens where the staff are educated and have implemented the new texture levels and testing methods, there have been some really positive outcomes.
“In particular it does offer the opportunity for increased creativity and agency within the catering team to expand texture modified meal offerings and check with the IDDSI testing methods for compliance.”
According to Cherie, the complexity of meal preparation in Aged Care surpasses that of restaurant meals. Dr Hugo is constantly impressed by the standard and innovation she sees in Aged Care kitchens as part of her work as a dietitian.
Because the rollout has been inconsistent, there are instances where a person returning from hospital will have a new texture level as per the IDDSI framework, but the facility they are returning to has yet to make the transition. This disconnect in communication requires additional discussion to resolve. Again, education about IDDSI is key to the success of the implementation.
Other issues which have arisen include the inadvertent mixing of different texture levels in a single meal - this can happen where a meal is predominantly moulded foods, with a sauce or gravy on top which is at a different texture level. Ensuring meals do not contain mixed consistency reduces the risk of residents receiving incorrect texture levels.