Name Change or Game Change?7 May 2019
The UK has now moved across to the IDDSI Framework to define drink and food textures for dysphagia diets. The RCSLT and BDA have endorsed the use of IDDSI (evidence, terminology and testing methods) to be used in the UK as of 1st April 2019. This has been a massive task and great credit should be given to the SLT teams across the UK that have made this possible. In order to make this complex process easier there has been a ‘mapping’ across from UK descriptor to IDDSI Level. This has raised the question many times, across healthcare professionals, chefs and carers… “How are the IDDSI Levels different to the UK descriptors or is it just a name change?”
Are the IDDSI Levels different?
We entered our kitchen over a year ago to create foods that would fit the IDDSI Levels for food. We started by taking foods that fitted the UK descriptors and testing them for IDDSI. Initially we couldn’t see much difference in the food textures we were making – something we realised was down to the subjective way we were looking at things.
However it became clearer when we spent time in the kitchen with Peter Lam, the Co-Chair of the IDDSI board. We saw how the IDDSI testing methods were objective in defining the characteristics of cohesiveness and stickiness. Furthermore we were able to build on this understanding by testing a wide range of ingredients. Consequently, we were able to remove the shackles of the old, subjective, UK descriptors.
By using the IDDSI testing methods we found it easier to define the characteristics of food textures. Making the food safer for people with dysphagia needed the objectiveness of the tests. It also struck us very clearly that, although there are similarities between the old UK descriptors and IDDSI, there are crucial differences. It can be easy to miss or ignore these differences if we simply think that IDDSI is changing the words used to define drinks and foods suitable for dysphagia.
Importantly, we’ve found this potential misunderstanding could prevent the success that the implementation of the IDDSI Framework should have in reducing the risk of aspiration and choking.
What makes the IDDSI Levels different?
Watch the clips…
We understand the difficulty in moving from one way of thinking to another. We have therefore put together a series of short clips for you to watch showing our understanding of these issues.
These show the IDDSI Testing methods; textural differences between IDDSI and the old UK descriptors; and look at how some foods may no longer be appropriate with IDDSI.
The clips have been shot at Oak House Residential Home, where a flower arranging session is in full swing in the background!
IDDSI Testing Methods
Firstly we take a look at the IDDSI testing methods that define the IDDSI Framework.
Secondly, we compare the old UK descriptors with the IDDSI Levels for food.
Finally we look at how certain foods have been re-evaluated under the IDDSI framework.
Let us know what you think
IDDSI have been very clear on the testing methods they have chosen and details can be found HERE on their website. While on the site you can sign up to their monthly e-Bite that this month covers the research behind the testing methods. This is a great resource that will keep you in the picture of developments in this area.
These are some of our thoughts on experiences working with the IDDSI Framework, terminology changes and the new testing methods. We would love to know what you think, and open up the conversation to develop our collective understanding. Get in touch easily by clicking HERE we look forward to hearing from you.