Dear Readers,
Sometimes while working in the medical setting, (especially with high turn over rate, and at times non-compliance) remaining on the same page regarding patients’ diets can be a challenge.
This post is to provide a resource and an open door to discuss diet textures with staff members. Let’s begin here.
Diet Texture In-service
Dysphagia (difficulty swallowing)
Aspiration (food/liquid enters the airway to the lungs)
Re: National Dysphagia Diet Guidelines
Solid Levels
Dysphagia Level 1: Pureed
Pudding-like smooth/even consistency, require very little chewing
Examples: Pureed meats, smooth pudding custards, yogurt (no fruit), pureed bread/rice, mashed potatoes, pureed vegetables without lumps, tomato sauce without seeds
Dysphagia Level 2: Mechanical Soft/Chopped
Moist, semi- solid foods (may have lumps), require some chewing
Examples: Moistened ground meat, soft and drained canned fruits/vegetables without seeds, soft fruit pies, custards, well cooked pasta noodles in sauce, moist cakes with icing, scrambled eggs
Dysphagia Level 3: Advanced Mechanical Soft
Closest to regular consistency, requires chewing
Examples: Tender or ground meats/poultry, well-moistened breads/muffins, canned and cooked fruits, peeled fresh fruits (soft berries, kiwis, cantaloupe), rice with gravy, tender fried potatoes
Regular Consistency
Liquid Levels
Pudding Thick
Does not flow off of spoon (should be eaten from the spoon).
Honey Thick
Slowly drips off of end of spoon
Nectar Thick
Runs off of spoon but leaves behind coating/residue (soup-like consistency)
Regular Thin Liquids (most difficult to swallow)
Runs off of spoon with no residue left behind
- Thickening liquids allows the liquid to travel more slowly so the muscles have more time to react in order to protect the airway.
- * Do not give a person with liquid restrictions anything that melts into a thin liquid (i.e. ice, ice cream, etc.)
- *Be cautious of foods that contain thin liquid (watermelon, etc.)
- Make sure fruits and vegetables are drained.
Overt s/s of Aspiration
Coughing/choking when eating or drinking
Throat clearing following swallow of food/liquid
Gurgly, wet voicing following swallow of food/liquid
Ways to Prevent Aspiration
When feeding a person with dysphagia:
Position patient to 90 degrees upright positioning prior to feeding
Administer small bites and sips
Alternate liquids and solids
Use a slow rate when feeding, allowing the patient to completely swallow food
Check for pocketed food between gums and cheeks
I hope this is useful!
Best regards,
Brittany Fontenot, M.A., CF-SLP
For God did not send His Son into the world to condemn the world, but to save the world.
John 3:17
