modified menus Flashcards
Diet Modification of a Normal Diet
3 types
The types of modifications that may have to be made are as follows:
1. In diet texture/consistency (ex. wired jaw)
- In nutrient content
3.In interval and frequency of feeding
(example 5 small meals)
Texture/Consistency Modifications
Texture modification is indicated for many different conditions including :
poor dentition (few/no teeth)
ill-fitting dentures, etc.
mouth sores
impaired swallowing /Dysphagia
oral motor problems oral surgery (jaw wired, etc.)
Goals for Nutritional Management
Prevent aspiration
Formal assessment of speech pathologist
Diet modification, patient positioning (sitting up, laying down), use of adaptive equipment, mealtime supervision (important for dysphagia)
Provide adequate nutrition
Use of dietary supplements and protein-rich food, energy dense foods
Short-term or long-term support may be necessary
Must consider family and patient wishes
Dietitians role in nutritional management
Risk screening
Education
Menu review
Nutrition (process) review
stage 1,2,3,4
1: pureed diet
2: minced diet
3: sental soft diet
4: regular diet
Other terms of classification:
Dysphagia Pureed- Pureed
Dysphagia Mechanically Altered- Minced
Dysphagia Advanced Diet- Soft
breakfast diet example for soft, minced, purree
breakfast for soft is fine
pureed - yes would work
minced- might half issue with muffin- add milk, butter
lunch example
soft: pull apart the pork, cut it up (mince it) and add soft gravy, for the potatoes- cut it up- add butter- take her time, brocoli: make sure its cooked properly and soft, whole wheat bread - take off the crust add some sauces- butter jam
mince (same as above)
puree- wopuld be fine
Soft Diet- Stage 3
Mainly used for patients with chewing problems related to dysphagia, mouth sores or poor dentition.
All foods must be in a soft form that is easily chewed.
Requires more chewing ability.
some degree of variability in terms of what some patients can & cannot chew.
Easy-to-cut meats, fruits, vegetables.
Excludes hard, crunchy fruits & vegetables, sticky foods, very dry foods.
Minced Diet – Stage 2
Often used with patients who have dysphagia or severe mouth sores or dentition problems.
They may also be offered as a progression from a pureed diet for a patient with mild swallowing difficulties.
Requires some chewing ability.
Foods on this diet require less cutting & chewing than those offered on a dental soft diet.
Should be processed to a particle size that allows passage through a 6 mm (1/4 inch) mesh screen
Should be prepared to achieve a moist & cohesive product
Minced /ground food should have no water separation.
Ground or minced meats with fork-mashable fruits & vegetables.
Excludes most bread products, crackers, & other dry foods.
(might miss out of nutrients- try to ad moistures)
Pureed diets
Needed for patients with Dysphagia, severe oral motor problems like jaw surgery or fracture
Processed until there are no visible particles (particle size of~1mm)
puree should be one homogenous color.
Pureed foods should have no water separation, when first scooped onto the plate.
Line Spread Test of less than 3 cm is recommended.
Requiring no chewing
Cohesive, pudding-like
Pureed Diets
Foods should not have coarse textures such as nuts, seeds, raw fruits or vegetables.
Pureed foods should be able to pass through a screen with a 2 mm mesh.
Sticky foods such as melted cheeses or peanut butter are not allowed.
Eg: apple sauce, pudding, smooth mashed potato, pureed scrambled eggs & cheese
why avoid oatmesl
can get sticky- should have cream of wheat instead
Equipment
Robot-Coupe Blixer Speed- 3450 rpm(max) Traditional blender-1750rpm (max) Strainers/mesh Various sizes
Breads
bread restriction
modified bread
mixed consistency
Bread Restrictions: Can be ordered in addition to other texture modifications. It is generally required for patients with swallowing difficulties whose needs fall between dental soft, minced and pureed diets. Avoid: bread, toast, cakes, crackers, rolls, cookies, cold cereal, buns, and muffins.
Modified Bread: Includes moistened bread products that can form a cohesive bolus!!!!! in the mouth. (examples: Salad sandwiches with crusts trimmed, pancakes or waffles with extra syrup, cake with cream or icing) These foods will sometimes be allowed in a diet that would otherwise exclude bread products.
Mixed Consistency: Includes foods that are made of two separate textures - a fluid and a solid. Examples include: Cereal with milk, soup with crackers or noodles, and fruit cocktail with juice. These foods pose additional challenges and should be avoided by individuals who have swallowing difficulties.
Thickened Fluids
Usually ordered with one of the other texture modified diets. It may also be ordered as “no thin liquids”.
Two reasons:
1) thickened liquids slow the progress of food down the throat in patients who have difficulty swallowing in order to give them greater control over the eating process
2) Keeps the fluids in a liquid diet from flowing down the trachea instead of the esophagus, possibly causing pneumonia to develop in the lungs
Other General Recommendations:
Do NOT allow items that will melt (ice cream, sherbet) for patients on thickened fluids
Do not send thickened milk unless requested; Blended soups with a thickening product are allowed
Do not send mixed textures/consistencies (e.g. soup with vegetables) if patient has dysphagia;
All fruit must be drained.
