Hints & Tips – Difficulty Swallowing

Difficulty swallowing can bring many challenges. Here you can find useful advice to help you overcome and improve your ability to enjoy drinks and mealtimes.

Drinks

There are plenty of drinks that can be made with a variety of textures. Smoothies and Milkshakes have a naturally thicker texture to juices and water. Look out for some drinks ideas in our recipe section.

There are also drinks available on the market which are suitable for the range of prescribed drinks textures Levels 1 to 4. Watch out for our blog on what foods and drinks are available to buy.

If you are using a prescribed thickener follow these simple rules:

• Always read the instructions, these vary depending on the brand
• Use the dispenser provided in the pack: if you have used another brand in the past you may find the size of dispenser is different and won’t be suitable
• Have everything ready to mix the drink before you start
• Mix immediately to prevent clumps that are very difficult to remove
• Allow hot drinks to cool slightly before thickening
• Stir fizzy drinks first to remove some of the fizz and prevent spillages
• You can thicken cold, hot, fizzy, and alcoholic drinks
• Be careful of using thickeners with naturally thicker fluids as these may end up too thick

Equipment

You will find that having some basic equipment will help you maximise the number of dishes available:

Basics – bowls, whisks, chopping boards, spatulas, peelers and sieves will all help you to work with your ingredients easily.

Knives – A combination of sharp and serrated blades of varying sizes will help you safely deal with a range of needs.

Processor – When smooth textured foods are needed a good food processor or blender will make life very easy.

Mixer – When physical tasks are difficult a good food mixer will allow you to mix and whisk quickly and effortlessly.

Preparation

Set out your food preparation area with all the things you need:

• Turn on the oven – This will help to speed things up
• Boards, utensils and equipment – Make sure you have what you need so your cooking can flow
• Bowls for prepared ingredients – Have somewhere to put the prepared ingredients as you go along
• Bag for rubbish – This means you can remove peelings, skin and other food stuffs to keep your area tidy
• Pans and boiling water – If you need to cook things in boiling water have this done beforehand to keep you on track

Once you have prepared your ingredients then you can cook without complications arising.

Food Modifications

When modifying foods to make them easier to eat some modifications are best made before cooking and some after:

Modify Before Cooking:

• Vegetables and Fruit
• Meat and Fish for one-pot wonder dishes

Modify After Cooking:

• Meat and Fish to be eaten with a sauce
• Vegetables (such as broccoli and cauliflower) that might crumble away when raw
• Foods to be blended

Fortification

Difficulties swallowing can impact greatly on an ability to eat a regular portion size. Fatigue or pain can mean that reduced portion sizes are consumed. To help increase the calorie and nutritional content of each mouthful additions of fats, protein and carbohydrate can be added.

• Oils and Fats – These foods contain 9 calories per gram so 10 gram additions of flavourless oils or butter give nearly 100 calorie boosts to dishes without affecting their taste.
• Cream – Can be added into both sweet and savoury dishes to enhance the energy available from food.
• Full Fat Yoghurts and Cheeses – Added protein can be very helpful in helping the body to recover or repair itself and with the added fats can bring a good boot to calories.
• Stocks – These contain many water soluble nutrients and bring added flavour to dishes.

Be careful not to over fortify food as its natural flavour can become lost and become unpalatable. Any food not eaten is wasted nutrition – taste it to make sure it’s delicious and you will find this is the key to a healthy diet.

Presentation

Some times modified foods can look a little off putting. If you are preparing something modified for someone else it is best to make it look as good as possible. Keeping foods separate will bring vibrant colours to the plate. There are other techniques using cutters, moulds and piping bags which can really elevate modified foods. There are many hints and tips on presenting foods throughout the Oak House Kitchen site.

Mealtimes

At mealtimes there is much that can be done to make eating more successful:

• Make sure you have good posture. Sitting upright will ensure everything is in line and make the process easier, more efficient and safer. This is best achieved in a chair, however if this is impossible, sitting upright in bed, supported by a couple of pillows will help.
• Limit the distractions. When eating and drinking is a challenge it is work making sure the environment is as complimentary as possible. Turn off the television or turn down any music. If you are helping someone to eat then time when you speak to them so they can concentrate on the process of eating. Safety of the swallow may be compromised if they have to open their airway to talk at the same time as swallowing.
• Allow enough time to eat. When eating becomes difficult it is naturally going to take longer to eat meals. Try not to start mealtimes if you are in a hurry. The likelihood is that problems will arise and not enough food will be eaten.
• Promote independence. If you are assisting someone to eat, where possible, try to get them to retain as much independence as possible. For example, if they cannot hold cutlery or a glass, they may be able to hold your wrist while you help them to eat or drink.