Caring with food: Catering for care home residents with Texture Modified Diets

Eating and drinking is not only essential for our health and nutrition, but mealtimes are also important for our wellbeing and can be a great opportunity for social interaction. For care home residents who have difficulties eating and drinking mealtimes may become less enjoyable and they may even start to avoid them altogether.

We asked Catering Support Manager Ivon Peplow to explain how care home chefs cater for residents with differing dietary requirements. In this blog, we look at Texture Modified Foods.

Ivon explains: It is not unusual for people living in care homes to have difficulties with eating and drinking. Our Chef Managers work closely with the care team to understand what is safe for them and any recommendations from the Speech and Language Therapy team.

What is a texture modified diet?

A texture modified diet will contain carefully selected foods of an appropriate consistency which can be more easily chewed and managed by a person with dysphagia. We are very careful to ensure that texture-modified meals offer adequate protein and energy. Meals can be fortified with butter, cream, oil, cheese, milk powder or cream cheese to boost nutrition.

What is dysphagia?

Dysphagia is the medical term for swallowing difficulties. Some people with dysphagia have problems swallowing certain foods or liquids whilst others can’s swallow at all. Signs of dysphagia can be coughing or choking whilst eating or drinking or bringing food back up.

Why are drinks thickened for someone with dysphagia?

Thickening liquids is meant to slow the flow of liquids to allow more time for airway closure, which reduces the risk of aspiration. It gives people better control over the liquid in their mouth, basically stopping it ‘going down the wrong way’.

Do texture modified meals look appetising?

Yes! We go to great lengths to ensure our texture modified meals are presented to the same high standards as any other dish. Our chefs have recently undertaken IDDSI training to help them recreate a texture modified dish to look as close as possible to the standard version of the same meal. We believe in treating ALL our residents with dignity and respect no matter what diet or IDDSI level they are on.

Are all texture modified dishes the same?

The IDDSI framework is a new global standard that defines seven levels for texture modified foods and drinks.  There are various levels of modification ranging from IDDSI Level 7 which are soft, easy to chew meals, they can be eaten with a fork, spoon or fingers. IDDSI Level 6 is for soft and tender foods that require some chewing but will be cut into bite-sized pieces. IDDSI Level 5 are often minced, they will be tender and moist with very little chewing required. IDDSI Level 4 is for pureed meals and IDDSI Level 3 is for liquidised foods with a soup-like consistency, foods will be thin and uniform. Drinks vary in thickness in a similar fashion from extremely thick to thin.

What types of foods can be modified?

You’d be surprised at what our chefs can achieve! We aim to ensure that all residents can enjoy the same menu where possible, we’ve created sandwiches and afternoon tea as texture modified variants. People assume they are going to be served soup and sloppy food every day, it’s really not like that at all. We use a range of techniques including piping food to look like vegetables and colouring to make dishes look browned or grilled.

Do all care and nursing homes offer texture modified dishes on their menus?

Yes, all Country Court Chef Managers are trained to create TMF dishes using the IDDSI framework. We regularly update all our chef’s skills with new training, share techniques and best practice. This month all our chefs have completed online training hosted from Robot Coupe headquarters who supply some of our kitchen equipment.

For more information about catering in our care homes, contact your nearest Home Manager. If you are interested in a career in catering in care home see our careers page.

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